Gwen Wyatt

Gwen Wyatt
Michigan State University | MSU · College of Nursing

PhD

About

123
Publications
11,449
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Introduction
Dr. Wyatt is an emeritus professor and also a fellow of the American Academy of Nursing (FAAN) and the American Psychosocial Oncology Society (FAPOS). Interest Areas: Cancer Care Symptom Management Quality of Life Complementary and Integrative Therapies End-of-Life Care

Publications

Publications (123)
Article
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Objective Family caregivers (FCGs) of cancer patients who are in hospice experience psychological challenges and poor quality of life (QOL) as a consequence of caregiving demands and anticipatory loss. Supportive interventions are needed. Exposure to nature offers a source of relaxation; however, FCGs are often homebound and have limited opportunit...
Article
Objectives Hospice family caregivers (CGs) may experience poor emotional health and diminished quality of life (QOL) secondary to stressors that accompany home-based end-of-life caregiving. Innovative flexible strategies are needed to support hospice CGs in their homes. Being outdoors in nature enhances well-being but is often not accessible to hom...
Article
Introduction: Due to their remote location, rural-dwelling family caregivers (FCGs) experience geographic and psychosocial challenges when providing home-based palliative and end-of-life (PEOL) care for their care recipient. Limited research has evaluated the social and environmental factors that may compound FCG burden and contribute to adverse em...
Article
Purpose: To address cancer screening disparities and reduce cancer risk among sexual minority (SM) groups, this review identifies individual, interpersonal, and community/societal determinants of cancer screening (non)participation among differing SM identities. Methods: Seven scientific databases were searched. Inclusion criteria were as follows:...
Article
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Home-based informal caregivers (CGs), such as the family members and friends of cancer patients, often suffer averse emotional symptoms, such as anxiety and depression, due to the burden associated with providing care. The natural environment has been valued as a healing sanctuary for easing emotional pain, promoting calmness, relaxation, and resto...
Article
Purpose: Although family involvement is critical to successful augmentative and alternative communication (AAC) device utilization, little is known about how families adapt to technology. The aim of this qualitative study was to explore parent-reported factors contributing to family adaptation among families with adolescents diagnosed with autism...
Article
Midcareer faculty are the “keystone” of academia. Faculty in midcareer experience an increase or change in responsibilities and expectations as well as reduced support and mentorship usually extended to junior faculty. Nonetheless, midcareer can be an ideal time for re-evaluating and defining one's career path and taking advantage of leadership and...
Article
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Aims: To identify and provide clarity on factors that influence coping and the type of coping strategies used by patients with heart failure (HF) to improve health-related quality of life (HRQoL). Methods and results: The Arksey and O'Malley template framed this scoping review guided by the stress and coping model. Five databases were explored:...
Article
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Purpose To conduct a secondary analysis focused on health-related quality of life (HRQOL) among caregivers engaged in a 12-week complementary therapy sequential multiple assignment randomized trial (SMART) of reflexology and/or meditative practices (MP), to manage cancer patients’ symptoms. Methods In this SMART, patient-caregiver dyads were initi...
Article
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Objective Ten-year retrospective study to assess burden of illness in patients with probable Dravet syndrome (DS) identified from German healthcare data. Methods In the absence of an International Classification of Diseases code, patients with probable DS were identified using a selection algorithm considering diagnoses and drug prescriptions. Pri...
Article
Background: Studies evaluating the use of meditative practices for supporting symptom management among patients undergoing cancer treatment have increased substantially in recent years. Although meditative practices as adjuncts to promoting health have become mainstream, concerns that such strategies conflict with traditional religious tenets have...
Article
Introduction: Coping is an essential element of self-management in chronic conditions such as heart failure (HF) where patients experience poor physical and emotional health outcomes. Coping strategies (problem-focused, active, and avoidant) often determine patients’ well-being. Although multiple factors are known to be associated with the selectio...
Article
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Home-based informal caregiving by friends and family members of patients with cancer is becoming increasingly common globally with rates continuing to rise. Such caregiving is often emotionally and cognitively demanding, resulting in mental exhaustion and high perceived burden. Support for caregivers may be fostered by engagement with the natural e...
Article
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Contact with nature has been used to promote both physical and mental health, and is increasingly used among cancer patients. However, the COVID-19 pandemic created new challenges in both access to nature in public spaces and in cancer care. The purpose of our study was to evaluate the change in active and passive use of nature, places of engaging...
Article
Introduction. Retrospective, 10-year (2007−2016) study reporting prevalence, patient characteristics, cost, hospitalisation, length of stay (LOS), medication, and mortality for patients with tuberous sclerosis complex (TSC), a rare, multisystemic, genetic disorder. Methods. Patients with TSC were identified from the German Vilua Healthcare research...
Article
Optimal sequencing of complementary therapies can help improve symptom management through nonpharmacological approaches. A 12‐week sequential multiple assignment randomized trial comparing home‐based reflexology and meditative practices on severity of fatigue and other symptoms was conducted among patients with cancer and their informal caregivers....
Article
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Purpose: 10-year retrospective study to assess burden of illness in individuals with tuberous sclerosis complex (TSC) identified from German healthcare data. Methods: Patients with TSC were identified by International Classification of Diseases code Q85.1. Patients with epilepsy were identified by epilepsy diagnosis or antiseizure medication (ASM)...
Article
(188/250 words) Purpose To evaluate factors associated with burden reported by caregivers of people undergoing treatment for solid tumor cancers. Methods A secondary analysis of baseline data collected in a cancer symptom management trial was conducted guided by the Organizing Framework for Caregiver Interventions. A total of 349 caregivers compl...
Article
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Background: Women with advanced breast cancer often experience significant pain. Previous studies indicate that spirituality may serve as a resource to alter pain perceptions; yet, the role of spirituality in pain management has not been examined as a lived experience among this population. Objective: This study qualitatively explored how women...
Article
Objectives: To examine pain and spirituality, demographic and clinical factors associated with pain and spirituality, the contribution of spirituality to experiences of pain over time, and how pain and spirituality relate to engagement with a caregiver-delivered intervention. Sample & setting: Women with advanced breast cancer (N = 256) enrolled...
Article
Objective Recent shifts in healthcare delivery and treatment for solid tumour cancer patients have modified the responsibilities of informal caregivers. The objective of this study was to: review informal caregiver burden factors and determine areas where future research is needed. Methods The Arksey and O’Malley’s framework and a modified Preferr...
Article
Full-text available
Objective This retrospective study examined patients with probable Lennox-Gastaut syndrome (LGS) identified from German healthcare data. Methods This 10-year study (2007–2016) assessed healthcare insurance claims information from the Vilua Healthcare research database. A selection algorithm considering diagnoses and drug prescriptions identified p...
Article
Background and Purpose The purpose was to examine the 8-item Inventory of Dimensions of Emerging Adulthood (IDEA-8) among 61 emerging adults (ages 18–29) with the chronic condition of inflammatory bowel disease (IBD). Methods An online continence sample of participants’ ages 18–29 years with a self-reported diagnosis of IBD completed a questionnai...
Article
The majority of research among individuals with inflammatory bowel disease (IBD) focuses on perceived social support. A gap exists regarding the role of received social support in self-management enhancement. The purpose of this study was to examine specific contextual factors (individual, condition-specific, and emerging adulthood factors) that in...
Article
Introduction While spirituality and quality of life (QOL) are essential components of end-of-life (EOL) care, limited studies have examined these constructs for indigenous peoples. Therefore, the purpose of this article was to examine the state of the science regarding spirituality and QOL at EOL for indigenous people, particularly Native Americans...
Article
Background Inflammatory bowel disease (IBD) refers to a group of incurable gastrointestinal diseases that are common among young adults. The present study aimed to describe dietary intake, self‐modifications and beliefs among adults aged 18–35 years with IBD and to compare those with active versus inactive disease. National guidelines for daily int...
Article
Families with children who have developmental disabilities and complex communication needs (CCNs) face challenging demands affecting family adaptation. Many children with CCNs use augmentative and alternative communication (AAC) devices to support communication, yet little is known about family adaptation to such technology. To fill this gap, an in...
Article
Purpose: Heart failure (HF) is associated with poor health-related quality of life (HRQoL) secondary to decrements in functional status. Patients’ adoption of coping strategies may affect their HRQoL. The review purpose was to characterize what is known about factors that impact selection of coping strategies that contribute to HRQoL among HF patie...
Article
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Purpose To examine symptom responses resulting from a home-based reflexology intervention delivered by a friend/family caregivers to women with advanced breast cancer undergoing chemotherapy, targeted, and/or hormonal therapy. Methods Patient-caregiver dyads (N = 256) were randomized to 4 weekly reflexology sessions or attention control. Caregiver...
Article
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Objective: Little is understood about patient expectations and use of complementary therapies (CT) during cancer treatment. A secondary analysis of an 11-week reflexology trial among women with breast cancer was conducted. We examined factors that predicted women's expectations about reflexology for symptom relief, factors that predicted utilisati...
Article
Background: The Long-Term Quality of Life (LTQL) instrument was designed for female cancer survivors who have completed treatment and includes an existential spirituality subscale that is omitted in many other quality of life scales. Women with advanced breast cancer are now living longer, while also expressing greater spiritual concerns. Objecti...
Article
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Objective: The recent American Society of Clinical Oncology (ASCO) Clinical Guidelines for chemotherapy-induced peripheral neuropathy (CIPN) management (48 Phase III trials reviewed) only recommend duloxetine. However, before concluding that a CIPN intervention is ineffective, scientists and clinicians should consider the risk of Type II error in...
Article
Individuals with inflammatory bowel disease (IBD) are commonly diagnosed when they are between the ages of 18–29, a developmental period known as emerging adulthood. Typically, emerging adults are subsumed into the category of adults even though emerging adults have unique developmental needs. In this descriptive study of IBD in emerging adults, th...
Article
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Purpose This project’s purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study. Methods A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two...
Article
Objective: To assess rationale for usage and types of complementary and integrative health therapies used as self-care by unpaid cancer caregivers. Data sources: CINAHL, PubMed, PsycINFO, Embase, and Alt HealthWatch. Conclusion: Six articles provide updated information on caregiver preferences and desires relative to use of complementary and i...
Article
Purpose: The purpose was to determine the relationship between social support, psychological symptoms and self-management behaviors among adults with inflammatory bowel disease (IBD) and examine the influence of types of social support and patient age. Design: This was a systematic review. PubMed, Web of Science, Cumulative Index to Nursing and...
Article
Objectives: The aim of the present review was to characterize how pain and spirituality have been conceptualized, assessed, and addressed and how these concepts may be related among women with advanced breast cancer. Design: A scoping review was conducted including publications of various methodologies. Data sources: Searches were conducted in...
Article
Background Emerging adulthood is a unique developmental stage, which may affect individuals’ self-management behaviors, social support, and the relationship between these two constructs. Among older adults, social support has been shown to improve self-management behaviors for individuals with chronic conditions; however, this relationship has not...
Article
Background Skeletal-related events (SREs), common sequelae of metastatic cancer, are reduced by bisphosphonates. In this study, it was postulated that radiopharmaceuticals, added to bisphosphonates, could further decrease the incidence of SREs. MethodsNRG Oncology RTOG 0517 randomized patients with breast, lung, and prostate cancer and blastic bone...
Article
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Objective Accurate and efficient measurement of patient‐reported outcomes is key in cancer symptom management trials. The newer Patient Reported Outcomes Measurement Information System (PROMIS) and previously developed measures of similar conceptual content (legacy) are available to measure symptoms and functioning. This report compares the perform...
Article
In this in-progress sequential multiple assignment randomized trial (SMART), dyads of solid tumor cancer patients and their caregivers are initially randomized to 4 weeks of reflexology or meditative (mindfulness) practices provided by/with their caregiver in the patient's home or to a control group. After 4 weeks, intervention group dyads in which...
Article
Purpose/Objectives: To determine the effects of delivering a reflexology intervention on health outcomes of informal caregivers, and to explore whether intervention effects are moderated by caregiver characteristics. Design: Two-group, randomized clinical trial. Setting: Eight oncology clinics in urban and rural regions of Michigan and Illinois. Sa...
Article
Purpose: To determine the effects of a home-based reflexology intervention delivered by a friend/family caregiver compared to attention control on health-related quality of life of women with advanced breast cancer undergoing chemotherapy, targeted and/or hormonal therapy. Methods: Patient-caregiver dyads (N=256) were randomized to 4 weekly refl...
Article
Aim: To evaluate and quantify intervention fidelity of a symptom management protocol through implementation of a scorecard, using an exemplar study of caregiver-delivered reflexology for breast cancer patients. Background: Studies on caregiver-delivered symptom management interventions seldom include adequate information on protocol fidelity, co...
Article
Context: The 15-item University of Washington Quality of Life questionnaire - Radiation Therapy Oncology Group (RTOG) modification (UW-QOL-RTOG modification) has been used in several trials of head and neck cancer conducted by NRG Oncology such as RTOG 9709, RTOG 9901, RTOG 0244, and RTOG 0537. Objectives: This study is an exploratory factor ana...
Article
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Purpose: The purpose of this secondary analysis was to determine change in overall health-related quality of life (HRQOL) based on patient data obtained from NRG Oncology RTOG 0537 as measured by the RTOG-modified University of Washington Head and Neck Symptom Score (RM-UWHNSS). Methods: A multi-site prospective randomized clinical trial design...
Article
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Context: Complementary therapies are frequently used by breast cancer patients for symptom management; however, documentation of the components of intervention fidelity for studies is not widely available. Objective: This report examines the components of intervention fidelity, as put forth by the Treatment Fidelity Workgroup of the Behavior Cha...
Article
This report presents the analysis of the RTOG 0537 multicenter randomized study that compared acupuncture-like transcutaneous stimulation (ALTENS) with pilocarpine (PC) for relieving radiation-induced xerostomia. Eligible patients were randomized to twice-weekly 20-minute ALTENS sessions for 24 sessions during 12 weeks or PC (5 mg 3 times daily for...
Article
Full-text available
Interruptions in medical treatment such as dose delays, reductions, or stoppages can lead to suboptimal treatment of cancer. Knowing how and for whom symptom severity and symptom interference with activities of daily living (ADL) are associated with treatment interruptions can guide behavioral interventions for supportive care. The purpose of this...
Article
Background: According to the National Center for Complementary and Alternative Medicine (NCCAM), about one-third of American cancer patients have used complementary and alternative medicine (CAM). Objective: The objective of this secondary analysis was an assessment of the use of other CAM by women with advanced breast cancer who were undergoing...
Article
Many patients with cancer use complementary and alternative medicine (CAM) therapies without essential knowledge to inform their decisions. A CAM knowledge instrument was developed and tested for initial validation. There were 20 items developed and refined via cognitive interviewing. The instrument was mailed to 800 breast cancer survivors, and ma...
Article
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Purpose/Objectives: To evaluate the safety and efficacy of reflexology, a complementary therapy that applies pressure to specific areas of the feet. Design: Longitudinal, randomized clinical trial. Setting: Thirteen community-based medical oncology clinics across the midwestern United States. Sample: A convenience sample of 385 predominantly Caucas...
Article
Background: Patients with lung cancer are in need of effective strategies to modify symptom burden and improve health-related quality of life (HRQOL). One promising approach to symptom management is an 8-week mindfulness-based intervention, which incorporates meditation, breathing, and gentle yoga exercises. It requires few resources to implement,...
Article
Full-text available
Background Despite high levels of clinically significant persistent cancer related fatigue in breast cancer survivors few treatments are currently available and most pose a significant burden on the part of the woman. Acupressure, a component of Traditional Chinese Medicine, has been shown to decrease fatigue levels by as much as 70% in cancer surv...
Article
Two sources of symptom data, patient report and medical records documentation, have been used in studies focusing on chronic conditions. The concordance of patient-reported cancer-related symptoms and clinician reports as documented in the medical records needs to be evaluated. To compare patient reports with medical record documentation of 12 dise...
Article
TPS9150 Background: Skeletal related events (SREs) diminish quality of life (QOL) as well as overall survival (OS) in patients with bone metastases, a common event in breast, lung and prostate cancer. SREs can be reduced or delayed by the use of bisphosphonates. It is postulated that the radiopharmaceuticals, Strontium-89 (Sr89) and Samarium-153 (S...
Article
Full-text available
In this phase 2 component of a multi-institutional, phase 2/3, randomized trial, the authors assessed the feasibility and preliminary efficacy of acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) in reducing radiation-induced xerostomia. Patients with cancer of the head and neck who were 3 to 24 months from completing radiothera...
Article
Multisite randomized clinical trials allow for increased research collaboration among investigators and expedite data collection efforts. As a result, government funding agencies typically look favorably upon this approach. As the field of complementary and alternative medicine (CAM) continues to evolve, so do increased calls for the use of more ri...
Article
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More than 80% of women with breast cancer are now reported to be using complementary and alternative medicine (CAM) therapies during conventional treatment. A randomized clinical trial (RCT) of reflexology with late stage breast cancer patients serves as the data source for this article. The purposes were to investigate: (i) reasons for refusal to...
Article
The purpose of this article is to share the lessons learned in forming an interdisciplinary team that implements a team science approach to integrative medicine (IM) research. The disciplines of nursing, statistics, and engineering, along with consultants and a reflexology practitioner, formed this university-based team to conceptualize and develop...
Conference Paper
Aims: The Treatment Fidelity Workgroup (TFW) established by the National Institutes of Health (NIH) provides a 5-point structure for intervention fidelity: dosing, interventionists’ consistency, intervention delivery, receipt and enactment of the intervention . The first three points are applied using a reflexology trial (R01 CA104883) as an exemp...
Article
The Treatment Fidelity Workgroup (TFW) established by the National Institutes of Health provides a 5-point structure for intervention fidelity: dosing, interventionists' consistency, intervention delivery, receipt, and enactment of the intervention. Using our reflexology trial, we apply the first 3 points. Study objectives were to (1) evaluate key...
Article
Up to 80% of women with breast cancer use complementary and alternative medicine (CAM) therapies to improve quality of life (QOL) during treatment. The objective of this study was to explore the association between CAM therapy use, spending on CAM therapies, demographic variables, surgical treatment, and QOL. A secondary analysis was conducted for...
Article
Complementary and alternative medicine (CAM) use is widespread among cancer patients. Information on safety and efficacy of CAM therapies is needed for both patients and healthcare providers. Well-designed randomized clinical trials of CAM therapy interventions can inform both clinical research and practice. The aim of this study was to review impo...
Article
Breast cancer is the leading type of cancer among women, and surgery is the primary treatment. The subacute phase of care after surgery has a significant impact on quality of life. This article explores the physical and psychological risk profiles of 240 women with early-stage cancer. Although several statistical models were designed for these data...
Article
Patient-reported outcomes (PROs) are often the primary end point in symptom management trials. The scientific field of PROs is evolving, as evidenced by the US Food and Drug Administration's February 2007 release of a draft guidance for using PROs in effectiveness claims for drug labeling. This article presents issues encountered during use of PROs...
Article
To evaluate patient characteristics to predict selection and maintenance of a complementary therapy and the feasibility of a randomized clinical trial (RCT) of complementary therapies. Quasi-experimental, exploratory study, unblinded and nonrandomized. A comprehensive cancer center in Michigan. 96 patients undergoing chemotherapy, predominantly Cau...
Article
The purpose of this secondary analysis was to glean from prospective data whether those caring for elderly family members recently diagnosed with cancer who ultimately died reported different caregiver depressive symptomatology and burden than caregivers of those who survived. Findings from interviews with 618 caregivers revealed that caregiver dep...
Article
Complementary therapies (CTs) are gaining popularity in the general population, including cancer patients, yet little is known about characteristics differentiating the use of one versus more CTs, about the patterns and persistence of CT use over time, or about the characteristics of cancer patients and their family caregivers who elect to particip...
Article
To identify key educational and scientific tasks for the incorporation of complementary and alternative medical therapies (CAM) into conventional health care. Journal articles, government and special health report, book chapters, and curriculum guidebooks. Nursing education programs are rapidly adding curricula on the practice and research of CAM t...
Article
Full-text available
A number of initiatives have been launched in recent years aimed at improving the quality of end-of-life care, particularly in the area of symptom management. Despite these efforts, however, many patients will not experience a peaceful death free of pain and suffering. A number of barriers continue to block efforts to ease symptom burden at the end...
Article
Full-text available
To examine the patient and family caregiver variables that predicted caregiver burden and depression for family caregivers of patients with cancer at the end of life. A prospective, longitudinal study was implemented with an inception cohort of patients and their family caregivers who were followed after the diagnosis and treatment of cancer. Commu...
Article
This randomized controlled trial (n = 240) was designed to test the efficacy of a sub-acute home nursing intervention following short-stay surgery for breast cancer. Intervention participants received the in-home nursing protocol, whereas non-intervention participants received agency nursing care or no nursing care. Data, collected via questionnair...