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Health Beliefs (health + belief)
Kinds of Health Beliefs Terms modified by Health Beliefs Selected AbstractsValidity assessment of the Breast Cancer Risk Reduction Health Belief scaleCANCER, Issue 21 2009Mfon Cyrus-David MBBS Abstract BACKGROUND: Women at increased risk of breast cancer (BC) are not widely accepting of chemopreventive interventions, and ethnic minorities are underrepresented in related trials. Furthermore, there is no validated instrument to assess the health-seeking behavior of these women with respect to these interventions. METHODS: By using constructs from the Health Belief Model, the authors developed and refined, based on pilot data, the Breast Cancer Risk Reduction Health Belief (BCRRHB) scale using a population of 265 women at increased risk of BC who were largely medically underserved, of low socioeconomic status (SES), and ethnic minorities. Construct validity was assessed using principal components analysis with oblique rotation to extract factors, and generate and interpret summary scales. Internal consistency was determined using Cronbach alpha coefficients. RESULTS: Test-retest reliability for the pilot and final data was calculated to be r = 0.85. Principal components analysis yielded 16 components that explained 64% of the total variance, with communalities ranging from 0.50-0.75. Cronbach alpha coefficients for the extracted factors ranged from 0.45-0.77. CONCLUSIONS: Evidence suggests that the BCRRHB yields reliable and valid data that allows for the identification of barriers and enhancing factors associated with use of breast cancer chemoprevention in the study population. These findings allow for tailoring treatment plans and intervention strategies to the individual. Future research is needed to validate the scale for use in other female populations. Cancer 2009. © 2009 American Cancer Society. [source] Breast Cancer Detection in Asymptomatic Women: Health Beliefs Implicated in Secondary PreventionJOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2003Kanayo Umeh This study assessed the usefulness of health belief model (HBM) constructs in predicting the frequency and proficiency of breast self-examination among Greek women. Both additive and multiplicative functions were tested. Cross-sectional data from 195 women were analyzed. Health beliefs explained 16.5% and 19.7% of the variance in frequency and proficiency, respectively. Frequent and proficient breast examination was associated with fewer perceived barriers. Moreover, elevated confidence and susceptibility estimates predicted greater frequency and proficiency, respectively. One moderator interaction emerged, but this was attenuated after accounting for other health beliefs. These findings provide qualified support for the HBM and present a useful template for developing interventions to promote secondary prevention. [source] Human Papillomavirus and Cervical Cancer Knowledge, Health Beliefs, and Preventative Practices in Older WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2010Kymberlee Montgomery ABSTRACT Objective: To explore knowledge of Human Papillomavirus (HPV) and cervical cancer, health beliefs, and preventative practices in women 40 to 70 years. Design: Cross-sectional descriptive. Setting: Three urban ambulatory Obstetrics and Gynecology offices connected with a teaching hospital's Department of Obstetrics and Gynecology in the Mid-Atlantic section of the United States. Participants: A convenience sample of 149 women age 40 to 70. Methods: To assess HPV and cervical cancer knowledge, health beliefs, and preventative practices a self-administered survey, the Awareness of HPV and Cervical Cancer Questionnaire was distributed to women as they waited for their well-woman gynecologic exam. Results: The mean knowledge score was 7.39 (SD=3.42) out of 15. One third of the questions about the relationship of HPV and risks for cervical cancer were answered incorrectly by more than 75% of these women. Although most appreciate the seriousness of cervical cancer, they believed themselves not particularly susceptible. Conclusion: There is a need for HPV and cervical cancer awareness and education for women older than age 40. Women's health care professionals are well positioned to act as a catalyst to improve HPV and cervical cancer knowledge, health beliefs, and preventative practice to ensure optimum health promotion for all women. [source] A Review of the Health Beliefs and Lifestyle Behaviors of Women with Previous Gestational DiabetesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 5 2009Emily J. Jones ABSTRACT Objective: To critically review and synthesize original research designed to examine the health beliefs, including risk perceptions and health behaviors related to diet and physical activity of women with previous gestational diabetes mellitus. Data Sources: PubMed and CINAHL databases were searched for studies published in the last decade (1998-2008) that examined variables related to the health beliefs and behaviors of women with previous gestational diabetes mellitus. Keyword searches included health beliefs, health behaviors, perceived risk, gestational diabetes, type 2 diabetes, diet, physical activity, and postpartum. Study Selection: Eight articles, representing 6 studies, were selected that met the inclusion criteria of original research, dependent variable of health beliefs and behaviors of women with previous gestational diabetes mellitus, and measurement after pregnancy. Data Extraction: Articles were reviewed and discussed according to the concepts of risk perception and health beliefs, health behaviors related to diet and physical activity, and psychosocial factors related to women's health beliefs and behaviors. Data Synthesis: Data revealed common health beliefs and behaviors of women with previous gestational diabetes mellitus, including low risk perceptions for future type 2 diabetes mellitus and suboptimal levels of physical activity and fruit and vegetable intake. The majority of studies revealed a distinct knowledge-behavior gap among women with previous gestational diabetes mellitus, whereas others revealed a lack of knowledge regarding necessary lifestyle modifications. Conclusions: Findings from this review may assist women's health researchers and clinicians in developing appropriate interventions for increasing risk awareness, promoting self-efficacy for weight loss and physical activity behaviors, and decreasing rates of diabetes and cardiovascular disease among women with previous gestational diabetes mellitus. Further research is necessary to identify factors that influence the health beliefs and behaviors of women with previous gestational diabetes mellitus. Future research should focus on populations of greater racial, ethnic, and socioeconomic diversity, as the majority of studies have been conducted with non-Hispanic White, socioeconomically advantaged women. [source] Health Beliefs toward Cardiovascular Risk Reduction in Patients Admitted to Chest Pain Observation UnitsACADEMIC EMERGENCY MEDICINE, Issue 5 2009David A. Katz MD Abstract Objectives:, Even after acute coronary syndrome (ACS) is ruled out, observational studies have suggested that many patients with nonspecific chest pain have a high burden of cardiovascular risk factors (CRFs) and are at increased long-term risk of ischemic heart disease (IHD)-related mortality. The aim of this study was to evaluate the premise that evaluation in an observation unit for symptoms of possible ACS is a "teachable moment" with regard to modification of CRFs. Methods:, The authors conducted a baseline face-to-face interview and a 3-month telephone interview of 83 adult patients with at least one modifiable CRF who presented with symptoms of possible ACS to an academic medical center. Existing questionnaires were adapted to measure Health Belief Model (HBM) constructs for IHD. Stage of change and self-reported CRF-related behaviors (diet, exercise, and smoking) were assessed using previously validated measures. The paired t-test or signed rank test was used to compare baseline and 3-month measures of health behavior within the analysis sample. Results:, Of the 83 study patients, 45 and 40% reported having received clinician advice regarding diet and physical activity during the observation unit encounter, respectively; 69% of current smokers received advice to quit smoking. Patients reported lower susceptibility to IHD (13.3 vs. 14.0, p = 0.06) and greater perceived benefit of healthy lifestyles (27.5 vs. 26.4, p = 0.0003) at 3-month follow-up compared to baseline. Patients also reported greater readiness to change and improved self-reported behaviors at follow-up (vs. baseline): decreased intake of saturated fat (10.1% vs. 10.5% of total calories, p = 0.005), increased fruit and vegetable intake (4.0 servings/day vs. 3.6 servings/day, p = 0.01), and fewer cigarettes (13 vs. 18, p = 0.002). Conclusions:, Observed changes in IHD health beliefs and CRF-related behaviors during follow-up support the idea that observation unit admission is a teachable moment. Patients with modifiable risk factors may benefit from systematic interventions to deliver CRF-related counseling during observation unit evaluation. [source] Chinese values in Singapore: Traditional and modernASIAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 1 2003Weining C. Chang A series of three studies was conducted to test the internal structure of the Chinese value hierarchy (CVH) in Singapore. Study 1 identified the empirically best,fit model with six factors: Prudence, Industry, Civic,Harmony, Moral Development, Social Power and Moderation. Relative magnitudes and interfactor correlations suggested that these factors could be further grouped into two superordinate clusters: (i) The Modern factor, with significantly higher magnitude, consisted of Prudence, Industry, Civic,Harmony and Moral Development; and (ii) the Tradition factor, with lower magnitude, consisted of Social Power and Moderation. Study 2 surveyed university students with differential preference for language usages: English or Chinese. Both language groups were equally high on the Modern factor, but the Chinese,language,preferred group showed a significantly higher endorsement for the Tradition factor, Chinese Worldview (CWV) and Chinese Health Beliefs (CHB). Further convergent validation for the Modern and the Tradition factors was provided by investigating their correlations with traditional Chinese beliefs and practices for the two language groups separately. Study 3 tested generation differences in CVH. University participants (Self) were compared with their parents (Parents) and friends (Friends). There were no differences between Self and Friends on both the Modern and Tradition factors, CWV and individual differences of modernity. Parents and Self did not differ on individual differences of modernity. Parents, however, were higher on the Modern factor, the Tradition factor and CWV. Results were discussed to support the concept of ,multiple modernity' (Tu, 1900) in Asian societies, and the ,revised convergence hypothesis' proposed by Yang (1988). [source] Patients' health beliefs and coping prior to autologous peripheral stem cell transplantationEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2007E. FRICK md The aim of this study was to determine the associations between health locus of control (LoC), causal attributions and coping in tumour patients prior to autologous peripheral blood stem cell transplantation. Patients completed the Questionnaire of Health Related Control Expectancies, the Questionnaire of Personal Illness Causes (QPIC), and the Freiburg Questionnaire of Coping with Illness. A total of 126 patients (45% women; 54% suffering from a multiple myeloma, 29% from non-Hodgkin lymphomas, and 17% from other malignancies) participated in the study. Cluster analysis yielded four LoC clusters: ,fatalistic external', ,powerful others', ,yeah-sayer' and ,double external'. Self-blaming QPIC items were positively correlated with depressive coping, and ,fate or destiny' attributions with religious coping (P < 0.001). The highest scores were found for ,active coping' in the LoC clusters ,powerful others' and ,yeah-sayer'. External LoC and an active coping style prevail before undergoing autologous peripheral blood stem cell transplantation, whereas the depressive coping is less frequent, associated with self-blaming causal attributions. Health beliefs include causal and control attributions, which can improve or impair the patient's adjustment. A mixture between internal and external attributions seems to be most adaptive. [source] Breast Cancer Detection in Asymptomatic Women: Health Beliefs Implicated in Secondary PreventionJOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2003Kanayo Umeh This study assessed the usefulness of health belief model (HBM) constructs in predicting the frequency and proficiency of breast self-examination among Greek women. Both additive and multiplicative functions were tested. Cross-sectional data from 195 women were analyzed. Health beliefs explained 16.5% and 19.7% of the variance in frequency and proficiency, respectively. Frequent and proficient breast examination was associated with fewer perceived barriers. Moreover, elevated confidence and susceptibility estimates predicted greater frequency and proficiency, respectively. One moderator interaction emerged, but this was attenuated after accounting for other health beliefs. These findings provide qualified support for the HBM and present a useful template for developing interventions to promote secondary prevention. [source] A qualitative investigation of the views and health beliefs of patients with Type 2 diabetes following the introduction of a diabetes shared care serviceDIABETIC MEDICINE, Issue 10 2003S. M. Smith Abstract Aims A qualitative research approach was adopted in order to explore the views and health beliefs of patients with Type 2 diabetes who had experienced a new structured diabetes shared care service. Methods Patients from 15 general practices were randomly selected and invited to attend three focus groups. Two independent researchers adopted the ,Framework' technique to analyse the transcribed data and identify key themes expressed by patients. Results Themes relating to diabetes included frustration, victimization and powerlessness in relation to living with diabetes, controlling blood sugar, medication and economic barriers to care. Differences in emphases between patients and healthcare providers emerged. Patients were generally positive about shared care and largely identified it with the nurses involved. Conclusion This research highlights the importance of an in-depth exploration of patients' views during changes in diabetes care delivery to identify service delivery failures and gaps in patient knowledge such as lack of awareness of the extent of macrovascular risk. [source] Patients' health beliefs and coping prior to autologous peripheral stem cell transplantationEUROPEAN JOURNAL OF CANCER CARE, Issue 2 2007E. FRICK md The aim of this study was to determine the associations between health locus of control (LoC), causal attributions and coping in tumour patients prior to autologous peripheral blood stem cell transplantation. Patients completed the Questionnaire of Health Related Control Expectancies, the Questionnaire of Personal Illness Causes (QPIC), and the Freiburg Questionnaire of Coping with Illness. A total of 126 patients (45% women; 54% suffering from a multiple myeloma, 29% from non-Hodgkin lymphomas, and 17% from other malignancies) participated in the study. Cluster analysis yielded four LoC clusters: ,fatalistic external', ,powerful others', ,yeah-sayer' and ,double external'. Self-blaming QPIC items were positively correlated with depressive coping, and ,fate or destiny' attributions with religious coping (P < 0.001). The highest scores were found for ,active coping' in the LoC clusters ,powerful others' and ,yeah-sayer'. External LoC and an active coping style prevail before undergoing autologous peripheral blood stem cell transplantation, whereas the depressive coping is less frequent, associated with self-blaming causal attributions. Health beliefs include causal and control attributions, which can improve or impair the patient's adjustment. A mixture between internal and external attributions seems to be most adaptive. [source] Smoking after the age of 65 years: a qualitative exploration of older current and former smokers' views on smoking, stopping smoking, and smoking cessation resources and servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2006Susan Kerr BA MSc PhD RN HV Abstract The aim of this study was to explore older current/former smokers' views on smoking, stopping smoking, and smoking cessation resources and services. Despite the fact that older smokers have been identified as a priority group, there is currently a dearth of age-related smoking cessation research to guide practice. The study adopted a qualitative approach and used the health belief model as a conceptual framework. Twenty current and former smokers aged , 65 years were recruited through general practices and a forum for older adults in the West of Scotland. Data were collected using a semistructured interview schedule. The audio-taped interviews were transcribed and then analysed using content analysis procedures. Current smokers reported many positive associations with smoking, which often prevented a smoking cessation attempt. The majority were aware that smoking had damaged their health; however, some were not convinced of the association. A common view was that ,the damage was done', and therefore, there was little point in attempting to stop smoking. When suggesting a cessation attempt, while some health professionals provided good levels of support, others were reported as providing very little. Some of the participants reported that they had never been advised to stop smoking. Knowledge of local smoking cessation services was generally poor. Finally, concern was voiced regarding the perceived health risks of using nicotine replacement therapy. The main reasons why the former smokers had stopped smoking were health-related. Many had received little help and support from health professionals when attempting to stop smoking. Most of the former smokers believed that stopping smoking in later life had been beneficial to their health. In conclusion, members of the primary care team have a key role to play in encouraging older people to stop smoking. In order to function effectively, it is essential that they take account of older smokers' health beliefs and that issues, such as knowledge of smoking cessation resources, are addressed. [source] Beliefs and beyond: what can we learn from qualitative studies of lay people's understandings of cancer risk?HEALTH EXPECTATIONS, Issue 2 2010Wendy L. Lipworth MBBS PhD Abstract Background, Clinicians and public health professionals are centrally concerned with mediating risk. However, people often resist the risk-related information that is communicated to them by experts, or have their own models of risk that conflict with expert views. Quantitative studies have clearly demonstrated the importance of health beliefs and various cognitive and emotional processes in shaping risk perception. More recently, a growing body of qualitative research has emerged, exploring lay conceptualizations, experiences and constructions of cancer risk. To date, this literature has not been synthesized. Objective, We report the findings of a synthesis of qualitative literature regarding the ways in which lay people construct and experience cancer risk. Design, We identified 87 articles and used the method of ,thematic synthesis' to identify and interpret key concepts from existing studies. Results, Eight analytic categories were developed: (i) perceptions of risk factors; (ii) process of risk perception; (iii) seeking control and taking responsibility (motivational factors); (iv) experiencing cancer directly; (v) constructing risk temporally; (vi) embodying risk; (vii) identifying with risk; and (viii) constructing risk in a social context. Conclusions, Qualitative enquiry can provide us with a rich and nuanced picture of the ways in which people understand, experience and construct risk and how being ,at risk' is managed, and can assist us in our communication with both individual patients and populations. [source] The Impact of Medicaid Managed Care on Pregnant Women in Ohio: A Cohort AnalysisHEALTH SERVICES RESEARCH, Issue 4p1 2004Embry M. Howell Objective. To examine the impact of mandatory HMO enrollment for Medicaid-covered pregnant women on prenatal care use, smoking, Cesarean section (C-section) use, and birth weight. Data Sources/Study Setting. Linked birth certificate and Medicaid enrollment data from July 1993 to June 1998 in 10 Ohio counties, 6 that implemented mandatory HMO enrollment, and 4 with low levels of voluntary enrollment (under 15 percent). Cuyahoga County (Cleveland) is analyzed separately; the other mandatory counties and the voluntary counties are grouped for analysis, due to small sample sizes. Study Design. Women serve as their own controls, which helps to overcome the bias from unmeasured variables such as health beliefs and behavior. Changes in key outcomes between the first and second birth are compared between women who reside in mandatory HMO enrollment counties and those in voluntary enrollment counties. County of residence is the primary indicator of managed care status, since, in Ohio, women are allowed to "opt out" of HMO enrollment in mandatory counties in certain circumstances, leading to selection. As a secondary analysis, we compare women according to their HMO enrollment status at the first and second birth. Data Collection/Extraction Methods. Linked birth certificate/enrollment data were used to identify 4,917 women with two deliveries covered by Medicaid, one prior to the implementation of mandatory HMO enrollment (mid-1996) and one following implementation. Data for individual births were linked over time using a scrambled maternal Medicaid identification number. Principal Findings. The effects of HMO enrollment on prenatal care use and smoking were confined to Cuyahoga County, Ohio's largest county. In Cuyahoga, the implementation of mandatory enrollment was related to a significant deterioration in the timing of initiation of care, but an improvement in the number of prenatal visits. In that county also, women who smoked in their first pregnancy were less likely to smoke during the second pregnancy, compared to women in voluntary counties. Women residing in all the mandatory counties were less likely to have a repeat C-section. There were no effects on infant birth weight. The effects of women's own managed care status were inconsistent depending on the outcome examined; an interpretation of these results is hampered by selection issues. Changes over time in outcomes, both positive and negative, were more pronounced for African American women. Conclusions. With careful implementation and attention to women's individual differences as in Ohio, outcomes for pregnant women may improve with Medicaid managed care implementation. Quality monitoring should continue as Medicaid managed care becomes more widespread. More research is needed to identify the types of health maintenance organization activities that lead to improved outcomes. [source] Use of the internet and of the NHS direct telephone helpline for medical information by a cognitive function clinic populationINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2003A. J. Larner Abstract Background Internet websites and medical telephone helplines are relatively new and huge resources of medical information (,cybermedicine' and ,telemedicine', respectively) accessible to the general public without prior recourse to a doctor. Study Objectives To measure use of internet websites and of the NHS Direct telephone helpline as sources of medical information by patients and their families and/or carers attending a cognitive function clinic. Design and Setting Consecutive patients seen by one consultant neurologist over a six-month period in the Cognitive Function Clinic at the Walton Centre for Neurology and Neurosurgery, a regional neuroscience centre in Liverpool, UK. Results More than 50% of patients and families/carers had internet access; 27% had accessed relevant information, but none volunteered this. 82% expressed interest in, or willingness to access, websites with relevant medical information if these were suggested by the clinic doctor. Although 61% had heard of the NHS Direct telephone helpline, only 10% of all patients had used this service and few calls related to the reason for attendance at the Cognitive Function Clinic. Conclusions Internet access and use is common in a cognitive function clinic population. Since information from internet websites may shape health beliefs and expectations of patients and families/carers, appropriately or inappropriately, it may be important for the clinic doctor to inquire about these searches. Since most would use websites suggested by the doctor, a readiness to provide addresses for appropriate sites may prove helpful. Copyright © 2003 John Wiley & Sons, Ltd. [source] Do cultural factors predict mammography behaviour among Korean immigrants in the USA?JOURNAL OF ADVANCED NURSING, Issue 12 2009Hanju Lee Abstract Title.,Do cultural factors predict mammography behaviour among Korean immigrants in the USA? Aim., This paper is a report of a study of the correlates of mammogram use among Korean American women. Background., Despite the increasing incidence of and mortality from breast cancer, Asian women in the United States of America report consistently low rates of mammography screening. A number of health beliefs and sociodemographic characteristics have been associated with mammogram participation among these women. However, studies systematically investigating cultural factors in relation to mammogram experience have been scarce. Methods., We measured screening-related health beliefs, modesty and use of Eastern medicine in 100 Korean American women in 2006. Hierarchical logistic regression was used to examine the unique contribution of the study variables, after accounting for sociodemographic characteristics. Findings., Only 51% reported past mammogram use. Korean American women who had previously had mammograms were statistically significantly older and had higher perceived benefit scores than those who had not. Perceived benefits (odds ratio = 6·3, 95% confidence interval = 2·12, 18·76) and breast cancer susceptibility (odds ratio = 3·18, 95% confidence interval = 1·06, 9·59) were statistically significant correlates of mammography experience, whereas cultural factors did not correlate. Post hoc analysis showed that for women with some or good English skills, cultural factors statistically significantly correlated with health beliefs and breast cancer knowledge (P < 0·05). Conclusion., Nurses should consider the inclusion in culturally tailored interventions of more targeted outreach and healthcare system navigation assistance for promoting mammography screening in Korean American women. Further research is needed to unravel the interplay between acculturation, cultural factors and health beliefs related to cancer screening behaviours of Korean American women. [source] Determinants of perceived barriers to condom use among HIV-infected middle-aged and older African-American menJOURNAL OF ADVANCED NURSING, Issue 4 2007Christopher Lance Coleman Abstract Title.,Determinants of perceived barriers to condom use among HIV-infected middle-aged and older African-American men Aim., This paper is a report of a study to describe which determinants best predict perceived barriers to condom use during sexual encounters among human immunodeficiency virus human immunodeficiency virus-infected African-American men, middle-aged and older, living in the United States of America. Background., While the global epidemic of acquired immunodeficiency syndrome infection is a well-documented phenomenon with national and international implications, prevalence statistics indicate that middle-aged and older African-American (non-Hispanic) men have not benefited from the prevention efforts implemented during the past two decades. Method., A cross-sectional design using a survey and convenience sampling was adopted between September 2003 and July 2004 to recruit n = 130 middle-aged human immunodeficiency virus-infected African-American men from infectious disease clinics from the Mid-Atlantic region in the United States of America. The survey covered demographics, perceived health beliefs, spiritual well-being and symptoms related to human immunodeficiency virus. Findings., Stepwise multiple regression showed having fewer human immunodeficiency virus-related symptoms associated with the human immunodeficiency virus (P = 0·004) and being single (P = 0·05) were perceived as barriers to condom use during sexual encounters (R2 = 0·029, P = 0·046). Conclusion., Tailored interventions are needed for African-American men, middle-aged and older, infected with human immunodeficiency virus nationally and worldwide that are designed to decrease perceived barriers in order to increase condom use. [source] Breast Cancer Detection in Asymptomatic Women: Health Beliefs Implicated in Secondary PreventionJOURNAL OF APPLIED BIOBEHAVIORAL RESEARCH, Issue 2 2003Kanayo Umeh This study assessed the usefulness of health belief model (HBM) constructs in predicting the frequency and proficiency of breast self-examination among Greek women. Both additive and multiplicative functions were tested. Cross-sectional data from 195 women were analyzed. Health beliefs explained 16.5% and 19.7% of the variance in frequency and proficiency, respectively. Frequent and proficient breast examination was associated with fewer perceived barriers. Moreover, elevated confidence and susceptibility estimates predicted greater frequency and proficiency, respectively. One moderator interaction emerged, but this was attenuated after accounting for other health beliefs. These findings provide qualified support for the HBM and present a useful template for developing interventions to promote secondary prevention. [source] Post-discharge health care needs of patients after lung cancer resectionJOURNAL OF CLINICAL NURSING, Issue 17-18 2010Kwua-Yun Wang Aims and objective., To determine the health care needs of patients after surgical resection of lung cancer at discharge and evaluate the significance of factors associated with such needs. Background., Other studies have found that symptom distress level, social supports and health beliefs are associated with health care needs. Design., Sixty-two participants were recruited from a thoracic surgery clinic at a medical centre in Taipei from July,December 2005. Data related to demographic variables, disease characteristics, functional status, symptom distress and social support were collected. Methods., The patients were administered the Karnofsky Performance Scale, the Symptom Distress Scale,Chinese Modified Form, the Social Support Scale (adapted from the Interpersonal Support Evaluation List), the Health Needs Scale and self-reported rating scales for pain. Data were analysed using Pearson's correlation coefficients and linear regression models. Results., Pulmonary function was found to be correlated with the level of need for health care information and physiological care. Self-perceived symptom distress and degree of distress were also correlated with levels of need for information, physiological care and psychosocial care. The level of pain was found to be correlated with the level of need for health care information and physiological care. After controlling for pain level, multivariate analysis revealed that self-perceived symptom severity (p = 0·032) and degree of distress (p = 0·043) were modestly correlated with the need for health care. Conclusions., Pulmonary function, self-perceived symptom distress, degree of distress and level of pain were correlated with the level of need for health care information and physiological care. Self-perceived symptom severity and degree of distress were independent predictors of health care needs. Relevance to clinical practice., Administration of relevant questionnaires to assess postoperative symptom distress may be necessary for optimal disease management. [source] A review of the factors involved in older people's decision making with regard to influenza vaccination: a literature reviewJOURNAL OF CLINICAL NURSING, Issue 1 2008Leigh Ward BSc Aims and objectives., The aim of this paper was to develop an understanding of the factors involved in older people's decision making with regard to influenza vaccination to inform strategies to improve vaccine uptake and reduce morbidity and mortality. Background., Influenza is a major cause of morbidity and mortality world-wide. In the UK, it accounts for 3000,6000 deaths annually; 85% of these deaths are people aged 65 and over. Despite this, and the widespread and costly annual government campaigns, some older people at risk of influenza and the associated complications remain reluctant to take advantage of the offer of vaccination. Methods., A review of the English language literature referring to older people published between 1996 and 2005 was the method used. Inclusion and exclusion criteria were identified and applied. Results., The majority of the literature was quantitative in nature, investigating personal characteristics thought to be predictors of uptake, such as age, sex, co-morbidity, educational level, income and area of residence. However, there was little discussion of the possible reasons for the significance of these factors and conflict between findings was often evident, particularly between studies employing different methodologies. Other factors identified were prior experience, concerns about the vaccine, perceived risk and advice and information. Relevance to clinical practice., The wealth of demographic information available will be useful at a strategic level in targeting groups identified as being unlikely to accept vaccination. However, the promotion of person-centred ways of working that value the health beliefs, attitudes, perceptions and subjective experiences of older people is likely to be more successful during individual encounters designed to promote acceptance. Without more research in investigating these concepts, our understanding is inevitably limited. [source] A health protection model for Hispanic adults with Type 2 diabetesJOURNAL OF CLINICAL NURSING, Issue 7b 2007Christine L Latham RN Aims., The Hispanic Health Protection Model (HHPM) was designed to assist practitioners' systematic assessment of Hispanic people to establish baselines and evaluate the success of early diabetes treatment. This article provides the research basis of the HHPM and related assessment tools. Background., The treatment of diabetes incorporates lifestyle change, and this adjustment is particularly important to follow with vulnerable groups. One such group is the Hispanic population, since the impact of diabetes is greatest on economically disadvantaged segments of this population, who suffer disproportionately higher Type 2 diabetes prevalence and higher levels of morbidity and mortality as compared with other populations. Traditional Hispanic health beliefs are often in conflict with Western medicine, so the adjustments to the lifestyle demands of this disease need to be evaluated. Methods., To understand this discrepancy fully in patient outcomes, a culturally sensitive assessment framework was developed based on health protection theories and research with Hispanic people with diabetes and, based on this framework, assessment tools were translated for use during interviews with low literacy, Spanish-speaking patients. Conclusions., The HHPM translated measures of premorbid lifestyle, health beliefs, support, self-efficacy, quality of life, knowledge of diabetes, and physiological parameters can be used during consecutive clinic visits during the first six months of therapy to map the success of patients' understanding of and psychological adjustment to diabetes. Relevance to clinical practice., The HHPM is a culturally-relevant, systematic, and holistic approach to assessing adjustment of Hispanic people to a new diagnosis of diabetes, including their psychological, cognitive, and physiological outcomes. Using this type of systematic approach will allow practitioners to target barriers to therapy, such as a lack of self-efficacy or incomplete knowledge of the disease and its treatment in a strategic manner to improve patient success in managing the complex lifestyle changes of diabetes mellitus. [source] Strategies to Facilitate Lifestyle Change Associated with Diabetes MellitusJOURNAL OF NURSING SCHOLARSHIP, Issue 3 2000Robin Whittemore Purpose: To critically examine the literature about strategies and factors that influence lifestyle change in people with diabetes mellitus. Method: This integrative literature review included an extensive search of published literature about strategies to facilitate lifestyle change related to diabetes mellitus. Articles reviewed were empirical studies focused on lifestyle change and were published between 1985 and 1999. Meta-analyses and relevant reviews of the literature were also included. Over 90 articles were initially identified, 72 met the specified criteria and could be categorized according to a theoretical framework or a broad topic area. Findings: Studies were clustered into the categories of educational, behavioral, cultural, and health beliefs that influence or are barriers to lifestyle change. Studies indicate that positive outcomes are associated with diabetes education programs that focus on self-management, emphasize behavioral strategies, and provide culturally relevant information. Conclusions: Theoretically grounded research in diabetes care is imperative for the future. Expansion of research methods, continued methodological rigor of studies, and instrument development would contribute to knowledge development in diabetes care. Research priorities are proposed. [source] Human Papillomavirus and Cervical Cancer Knowledge, Health Beliefs, and Preventative Practices in Older WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 3 2010Kymberlee Montgomery ABSTRACT Objective: To explore knowledge of Human Papillomavirus (HPV) and cervical cancer, health beliefs, and preventative practices in women 40 to 70 years. Design: Cross-sectional descriptive. Setting: Three urban ambulatory Obstetrics and Gynecology offices connected with a teaching hospital's Department of Obstetrics and Gynecology in the Mid-Atlantic section of the United States. Participants: A convenience sample of 149 women age 40 to 70. Methods: To assess HPV and cervical cancer knowledge, health beliefs, and preventative practices a self-administered survey, the Awareness of HPV and Cervical Cancer Questionnaire was distributed to women as they waited for their well-woman gynecologic exam. Results: The mean knowledge score was 7.39 (SD=3.42) out of 15. One third of the questions about the relationship of HPV and risks for cervical cancer were answered incorrectly by more than 75% of these women. Although most appreciate the seriousness of cervical cancer, they believed themselves not particularly susceptible. Conclusion: There is a need for HPV and cervical cancer awareness and education for women older than age 40. Women's health care professionals are well positioned to act as a catalyst to improve HPV and cervical cancer knowledge, health beliefs, and preventative practice to ensure optimum health promotion for all women. [source] A Review of the Health Beliefs and Lifestyle Behaviors of Women with Previous Gestational DiabetesJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 5 2009Emily J. Jones ABSTRACT Objective: To critically review and synthesize original research designed to examine the health beliefs, including risk perceptions and health behaviors related to diet and physical activity of women with previous gestational diabetes mellitus. Data Sources: PubMed and CINAHL databases were searched for studies published in the last decade (1998-2008) that examined variables related to the health beliefs and behaviors of women with previous gestational diabetes mellitus. Keyword searches included health beliefs, health behaviors, perceived risk, gestational diabetes, type 2 diabetes, diet, physical activity, and postpartum. Study Selection: Eight articles, representing 6 studies, were selected that met the inclusion criteria of original research, dependent variable of health beliefs and behaviors of women with previous gestational diabetes mellitus, and measurement after pregnancy. Data Extraction: Articles were reviewed and discussed according to the concepts of risk perception and health beliefs, health behaviors related to diet and physical activity, and psychosocial factors related to women's health beliefs and behaviors. Data Synthesis: Data revealed common health beliefs and behaviors of women with previous gestational diabetes mellitus, including low risk perceptions for future type 2 diabetes mellitus and suboptimal levels of physical activity and fruit and vegetable intake. The majority of studies revealed a distinct knowledge-behavior gap among women with previous gestational diabetes mellitus, whereas others revealed a lack of knowledge regarding necessary lifestyle modifications. Conclusions: Findings from this review may assist women's health researchers and clinicians in developing appropriate interventions for increasing risk awareness, promoting self-efficacy for weight loss and physical activity behaviors, and decreasing rates of diabetes and cardiovascular disease among women with previous gestational diabetes mellitus. Further research is necessary to identify factors that influence the health beliefs and behaviors of women with previous gestational diabetes mellitus. Future research should focus on populations of greater racial, ethnic, and socioeconomic diversity, as the majority of studies have been conducted with non-Hispanic White, socioeconomically advantaged women. [source] Selected Internet Sites for Transcultural Health QuestionsJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2002Mary Sobralske (PhD(c)) ARNP Are you new to the Internet and want some tips on findings sites that will help you in clinical practice? Maybe you are Internet savvy, but don't have the time to go searching for sites on transcultural health. Want the work done for you? This is a handy guide that discusses some selected Internet sites on questions you may have about your patients' health beliefs and their culture. Here are tips for improving communication and assessment of your ethnically and culturally diverse patients. [source] Review article: medication non-adherence in ulcerative colitis , strategies to improve adherence with mesalazine and other maintenance therapiesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 12 2008A. B. HAWTHORNE Summary Background, Significant number of patients with ulcerative colitis (UC) fail to comply with treatment. Aims, To review issues surrounding medication non-adherence in inflammatory bowel disease (IBD), including the clinical and health service implications in the UK, and discuss strategies for optimizing medication adherence. Methods, Articles cited were identified via a PubMed search, utilizing the words IBD, adherence, compliance, medication and UC. Results, Medication non-adherence is multifactorial involving factors other than dosing frequency. Male gender (OR: 2.06), new patient status (OR: 2.14), work and travel pressures (OR: 4.9) and shorter disease duration (OR: 2.1), among others are proven predictors of non-adherence in UC. These indicators can identify ,at-risk' patients and allow an individually tailored treatment approach to be introduced that optimizes medication adherence. A collaborative relationship between physician and patient is important; several strategies for improving adherence have been proven effective including open dialogue that takes into consideration the patient's health beliefs and concerns, providing educational (e.g. verbal/written information, self-management programmes) and behavioural interventions (e.g. calendar blister packs, cues/reminders). Conclusions, Educational and behavioural interventions tailored to individual patients can optimize medication adherence. Additional studies combining educational and behavioural interventions may provide further strategies for improving medication adherence rates in UC. [source] The Idea of Health: History, Medical Pluralism, and the Management of the Body in Emilia-Romagna, ItalyMEDICAL ANTHROPOLOGY QUARTERLY, Issue 3 2003Elizabeth D. Whitaker Basic beliefs about health in north central Italy derive from an approach to the personal management of the body that is not just reactive but also proactive. This article examines a complex field of health factors in relation to historical processes and a system of medical pluralism. Rapid demographic and social changes over the past century have brought an accommodation of ancient medical beliefs to more recent germ-oriented principles. An enduring belief in the permeability of the body leads to an emphasis on moderation in personal conduct to prevent debilitation, whether by atmospheric insults, microbial infection, or modern-day miasmas such as pollution or additives in food. The idea of health itself is analyzed to show how biomedicine varies across societies and how historical processes have shaped contemporary cultural patterns and led to generational continuities and differences in beliefs and behaviors. This information may also improve interactions between patients and health care providers, [health beliefs, Italy, Emilia-Romagna, humoral medicine, medical pluralism] [source] Complementary medicine use by Australian women with gynaecological cancerPSYCHO-ONCOLOGY, Issue 3 2006Milica Markovic Abstract Aims and objectives: Social and cultural factors are identified that impact on complementary therapy use among Australia-born and immigrant women diagnosed with gynaecological cancer. Methods: A qualitative study design including in-depth interviews with women diagnosed with gynaecological cancer (N=53) and participant observation was conducted. Results: Approximately one-third of women utilized complementary and alternative medicine, with this being determined by current health concerns and health beliefs related to the efficacy of different modalities. Four types of complementary therapy users emerged: consequential, therapeutic, informed and exploratory. Conclusion: There was a relatively low uptake of complementary treatments. Choice was influenced by women's socio-demographic background, clinical and personal history, lack of personal experiences of gynaecological cancer among study participants' kin and friends, and lack of popular alternative literature on such cancer. Copyright © 2005 John Wiley & Sons, Ltd. [source] Perspectives on Health Among Adult Users of Illicit Stimulant Drugs in Rural OhioTHE JOURNAL OF RURAL HEALTH, Issue 2 2006Harvey A. Siegal PhD ABSTRACT:,Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may affect their utilization of health care services. Methods: A respondent-driven sampling plan was used to recruit 249 not-in-treatment, nonmedical stimulant drug users who were residing in 3 rural counties in west central Ohio. A structured questionnaire administered by trained interviewers was used to collect information on a range of topics, including current drug use, self-reported health status, perceived need for substance abuse treatment, and beliefs about health and health services. Findings: Participants reported using a wide variety of drugs nonmedically, some by injection. Alcohol and marijuana were the most commonly used drugs in the 30 days prior to the interview. Powder cocaine was used by 72.3% of the sample, crack by 68.3%, and methamphetamine by 29.7%. Fair or poor health status was reported by 41.3% of the participants. Only 20.9% of the sample felt they needed drug abuse treatment. Less than one third of the sample reported that they would feel comfortable talking to a physician about their drug use, and 65.1% said they preferred taking care of their problems without getting professional help. Conclusions: Stimulant drug users in rural Ohio are involved with a range of substances and hold health beliefs that may impede health services utilization. [source] Unemployment as Illness: An Exploration of Accounts Voiced by the Unemployed in Aotearoa/New ZealandANALYSES OF SOCIAL ISSUES & PUBLIC POLICY, Issue 1 2001Andrea Cullen In Aotearoa/New Zealand unemployment is a continuing social concern that has been linked to a range of negative consequences, including various psychological and physical ailments. Whereas findings linking unemployment to such conse-quences are highly prevalent, few studies have explored people's experiences of unemployment. This article presents an analysis of 26 semistructured individual interviews with unemployed people in order to explore the social construction of unemployment. It is argued that the meaning of unemployment is in many respects analogous to what previous research on lay health beliefs has found regarding the meaning of illness. Prominent themes from literature on the meaning of illness are used to inform an analysis of the meaning of unemployment. The implications of constructing unemployment as an illness are explored in relation to the assignment of cause and responsibility and to the ways the unemployed are socially positioned. Tactics used by participants to preserve a sense of moral worth in response to the stigma of unemployment provide a key focal point for this article. [source] Health Beliefs toward Cardiovascular Risk Reduction in Patients Admitted to Chest Pain Observation UnitsACADEMIC EMERGENCY MEDICINE, Issue 5 2009David A. Katz MD Abstract Objectives:, Even after acute coronary syndrome (ACS) is ruled out, observational studies have suggested that many patients with nonspecific chest pain have a high burden of cardiovascular risk factors (CRFs) and are at increased long-term risk of ischemic heart disease (IHD)-related mortality. The aim of this study was to evaluate the premise that evaluation in an observation unit for symptoms of possible ACS is a "teachable moment" with regard to modification of CRFs. Methods:, The authors conducted a baseline face-to-face interview and a 3-month telephone interview of 83 adult patients with at least one modifiable CRF who presented with symptoms of possible ACS to an academic medical center. Existing questionnaires were adapted to measure Health Belief Model (HBM) constructs for IHD. Stage of change and self-reported CRF-related behaviors (diet, exercise, and smoking) were assessed using previously validated measures. The paired t-test or signed rank test was used to compare baseline and 3-month measures of health behavior within the analysis sample. Results:, Of the 83 study patients, 45 and 40% reported having received clinician advice regarding diet and physical activity during the observation unit encounter, respectively; 69% of current smokers received advice to quit smoking. Patients reported lower susceptibility to IHD (13.3 vs. 14.0, p = 0.06) and greater perceived benefit of healthy lifestyles (27.5 vs. 26.4, p = 0.0003) at 3-month follow-up compared to baseline. Patients also reported greater readiness to change and improved self-reported behaviors at follow-up (vs. baseline): decreased intake of saturated fat (10.1% vs. 10.5% of total calories, p = 0.005), increased fruit and vegetable intake (4.0 servings/day vs. 3.6 servings/day, p = 0.01), and fewer cigarettes (13 vs. 18, p = 0.002). Conclusions:, Observed changes in IHD health beliefs and CRF-related behaviors during follow-up support the idea that observation unit admission is a teachable moment. Patients with modifiable risk factors may benefit from systematic interventions to deliver CRF-related counseling during observation unit evaluation. [source] |