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Vincent C, Fenge L, Porter S, Holland S. Exploring Whether and How People Experiencing High Deprivation Access Diagnostic Services: A Qualitative Systematic Review. Health Expect 2024; 27:e14142. [PMID: 39010641 PMCID: PMC11250414 DOI: 10.1111/hex.14142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/03/2024] [Accepted: 06/16/2024] [Indexed: 07/17/2024] Open
Abstract
INTRODUCTION To contribute to addressing diagnostic health inequalities in the United Kingdom, this review aimed to investigate determinants of diagnostic service use amongst people experiencing high deprivation in the United Kingdom. METHODS A systematic review was conducted using three databases (EBSCO, Web of Science and SCOPUS) to search studies pertaining to diagnostic service use amongst people experiencing high deprivation. Search terms related to diagnostics, barriers and facilitators to access and deprivation. Articles were included if they discussed facilitators and/or barriers to diagnostic service access, contained participants' direct perspectives and focussed on individuals experiencing high deprivation in the United Kingdom. Articles were excluded if the full text was unretrievable, only abstracts were available, the research did not focus on adults experiencing high deprivation in the United Kingdom, those not including participants' direct perspectives (e.g., quantitative studies) and papers unavailable in English. RESULTS Of 14,717 initial papers, 18 were included in the final review. Determinants were grouped into three themes (Beliefs and Behaviours, Emotional and Psychological Factors and Practical Factors), made up of 15 sub-themes. These were mapped to a conceptual model, which illustrates that Beliefs and Behaviours interact with Emotional and Psychological Factors to influence Motivation to access diagnostic services. Motivation then influences and is influenced by Practical Factors, resulting in a Decision to Access or Not. This decision influences Beliefs and Behaviours and/or Emotional and Psychological Factors such that the cycle begins again. CONCLUSION Decision-making regarding diagnostic service use for people experiencing high deprivation in the United Kingdom is complex. The conceptual model illustrates this complexity, as well as the mediative, interactive and iterative nature of the process. The model should be applied in policy and practice to enable understanding of the factors influencing access to diagnostic services and to design interventions that address identified determinants. PATIENT OR PUBLIC CONTRIBUTION Consulting lived experience experts was imperative in understanding whether and how the existing literature captures the lived experience of those experiencing high deprivation in South England. The model was presented to lived experience experts, who corroborated findings, highlighted significant factors for them and introduced issues that were not identified in the review.
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Affiliation(s)
- Christine Vincent
- Department of Social Sciences and Social Work, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
| | - Lee‐Ann Fenge
- Department of Social Sciences and Social Work, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
| | - Sam Porter
- Department of Social Sciences and Social Work, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
| | - Sharon Holland
- Department of Nursing Science, Faculty of Health and Social SciencesBournemouth UniversityBournemouthUK
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Lin C, Tu P, Parker T, Mella-Velazquez A, Bier B, Braund WE. The Influences of SES on Patient Choice of Doctor: A Systematic Review. Am J Prev Med 2024:S0749-3797(24)00210-1. [PMID: 38906427 DOI: 10.1016/j.amepre.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION As patients become increasingly involved in healthcare decision-making, it is important to examine the drivers behind patient choice of doctor (PCOD); the initial decision can have lasting impacts on patients' trust in providers and health outcomes. However, limited studies have explored PCOD relative to socioeconomic status (SES) or health disparity. This review identified similar preferences and varied decision criteria in PCOD across SES groups. METHODS PubMed, PsycINFO, Web of Science, and relevant cross-references were searched for articles published between January 2007-September 2022. Papers were screened using Covidence. Included studies examined PCOD by income and/or educational levels. Analysis was performed in 2022-2023. RESULTS From 4,449 search results, 29 articles were selected (16 countries, 14 medical specialties, total of 32,651 participants). Individuals of higher SES ranked physician characteristics (e.g., qualifications, empathy) or performance more important than cost or convenience. Individuals of lower SES often had to prioritize logistical factors (e.g., insurance coverage, distance) due to resource constraints and gaps in knowledge or awareness about options. Despite differing healthcare systems, such divergence in PCOD were relatively consistent across countries. Some patients, especially females and disadvantaged groups, favored gender-concordant physicians for intimate medical matters (e.g., gynecologist); this partiality was not limited to conservative cultures. Few researchers investigated the outcomes of PCOD and indicated that lower-SES populations inadvertently chose, experienced, or perceived lower quality of care. DISCUSSION Patients' decision criteria varied by SES, even under national systems intended for universal access, indicating the impacts of social determinants and structural inequities. Health education supporting patient decision-making and research on how SES affects PCOD and outcomes could help reduce health disparity.
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Affiliation(s)
- Cheryl Lin
- Policy and Organizational Management Program, Duke University, Durham, North Carolina
| | - Pikuei Tu
- Policy and Organizational Management Program, Duke University, Durham, North Carolina.
| | - Taylor Parker
- Policy and Organizational Management Program, Duke University, Durham, North Carolina
| | | | - Brooke Bier
- Policy and Organizational Management Program, Duke University, Durham, North Carolina
| | - Wendy E Braund
- Pennsylvania Department of Health, Harrisburg, Pennsylvania
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González Leone MF, Donizzetti AR, Bianchi M, Lemmo D, Martino ML, Freda MF, Caso D. Users' Experience of Public Cancer Screening Services: Qualitative Research Findings and Implications for Public Health System. Behav Sci (Basel) 2024; 14:139. [PMID: 38392492 PMCID: PMC10885925 DOI: 10.3390/bs14020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
Following the One Health approach, designing multidimensional strategies to orient healthcare in promoting health and preventive processes has become paramount. In particular, in the prevention domain, cancer screening attendance is still unsatisfactory in many populations and requires specific consideration. To this end, following a research-intervention logic, this study aims to investigate the experiences and meanings that users of public cancer screening services associate with prevention, particularly participation in the screenings. The experiences of 103 users (96 females; Mage = 54.0; SD = 1.24) of public cancer screening programs in the Campania region (Italy) were collected through interviews. The data collected were analysed following the Grounded Theory Methodology, supported by the software Atlas.ti 8.0. The text material was organised into eight macro-categories: Health and Body; Relationship with Cancer and Diseases; Health Facilities and Health Providers; The Affective Determinants of Cancer Screening Participation; Partners and Children; Physical Sensations and Emotions in the Course of Action; Protective Actions; Promotion and Dissemination. The core category was named Family and Familiarity. Respondents perceived prevention as an act of care for the family and themselves. Our findings support a shift from the idea of taking care of personal health as an individual matter toward considering it as a community issue, according to which resistance to act is overcome for and through the presence of loved ones. The results of this study contribute to a deeper understanding of the perspectives of southern Italian users on participation in cancer screening, and provide important insights to guide future actions to promote these public programmes based primarily on the emerging theme of family and familiarity related to screening programs.
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Affiliation(s)
| | | | - Marcella Bianchi
- Department of Humanities, University of Naples Federico II, 80133 Naples, Italy
| | - Daniela Lemmo
- Department of Humanities, University of Naples Federico II, 80133 Naples, Italy
| | - Maria Luisa Martino
- Department of Humanities, University of Naples Federico II, 80133 Naples, Italy
| | | | - Daniela Caso
- Department of Humanities, University of Naples Federico II, 80133 Naples, Italy
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Frosch ZAK, Jacobs LM, O'Brien CS, Brecher AC, McKeown CJ, Lynch SM, Geynisman DM, Hall MJ, Edelman MJ, Bleicher RJ, Fang CY. "Cancer's a demon": a qualitative study of fear and multilevel factors contributing to cancer treatment delays. Support Care Cancer 2023; 32:13. [PMID: 38060063 DOI: 10.1007/s00520-023-08200-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE Delays initiating cancer therapy are increasingly common, impact outcomes, and have implications for health equity. However, it remains unclear (1) whether patients' beliefs regarding acceptable diagnostic to treatment intervals align with current guidelines, and (2) to what degree psychological factors contribute to longer intervals. We conducted a qualitative study with patients and cancer care team members ("providers"). METHODS We interviewed patients with several common solid tumors as well as providers. Interviews were analyzed using an interpretive approach, guided by modified grounded theory. RESULTS Twenty-two patients and 12 providers participated. Half of patients had breast cancer; 27% waited >60 days between diagnosis and treatment. Several themes emerged. (1) Patients felt treatment should begin immediately following diagnosis, while providers' opinion on the goal timeframe to start treatment varied. (2) Patients experienced psychological distress while waiting for treatment. (3) Participants identified logistical, social, and psychological sources of delay. Fear related to multiple aspects of cancer care was common. Emotion-driven barriers could manifest as not taking steps to move ahead, or as actions that delayed care. (4) Besides addressing logistical challenges, patients believed that education and anticipatory guidance, from their care team and from peers, may help overcome psychological barriers to treatment and facilitate the start of therapy. CONCLUSIONS Patients feel an urgency to start cancer therapy, desiring time frames shorter than those included in guidelines. Psychological distress is frequently both a contributor to, and a consequence of, treatment delays. Addressing multilevel barriers, including psychological ones, may facilitate timely treatment and reduce distress.
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Affiliation(s)
- Zachary A K Frosch
- Department of Hematology/Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA.
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA.
| | - Lisa M Jacobs
- Mixed Methods Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Caroline S O'Brien
- Mixed Methods Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA
| | - Alison C Brecher
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Colleen J McKeown
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Shannon M Lynch
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Daniel M Geynisman
- Department of Hematology/Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Michael J Hall
- Department of Hematology/Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Martin J Edelman
- Department of Hematology/Oncology, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
| | - Richard J Bleicher
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Carolyn Y Fang
- Cancer Prevention and Control Research Program, Fox Chase Cancer Center, 333 Cottman Ave, Philadelphia, PA, 19111, USA
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Elsheikh E, AlKhudair AM, AlGanem SN, AlDandan HR, AlGhareeb AH, AlSalman MA, AlKhamis AA, AlHajri HM, Alsubaie GA. Perception of Heart Attack Risk Factors and Their Complications Among the Adult Population in the Eastern Region of Saudi Arabia. Cureus 2023; 15:e49860. [PMID: 38170093 PMCID: PMC10758995 DOI: 10.7759/cureus.49860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Background Among the young population, many have risk factors that are nonmodifiable, modifiable, or both, increasing their chances of developing cardiovascular diseases (CVDs) and/or experiencing a heart attack later in life. Knowledge of both risk factors has a major role in preventing CVD by encouraging screening and applying the necessary lifestyle modifications. This study aims to assess the knowledge of risk factors and complications associated with heart attacks among individuals in the early adulthood age group. Methodology This descriptive cross-sectional study encompassed residents of the Eastern Region who met the specified inclusion criteria. Data were collected and recorded on a structured questionnaire regarding their demographic information, current risk factors, and knowledge of cardiovascular risk factors and complications. The questionnaire was distributed in hard copy among schools, colleges, and primary healthcare centers. The statistical analysis was carried out using IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY). The results were presented in tables as percentages and frequencies for all variables, and the scores were presented as mean and standard deviation. Results Among the 334 participants, the average overall score was 15.47 out of 28. The participants exhibited varying levels of knowledge across different aspects of the risk factors. The correct response rate ranged from as high as 84.4% (282) to as low as 41.6% (139) in the assessment of risk factors items. The majority of the participants showed a good understanding of the preventive measures, such as exercise and weight reduction. However, 43.4% (145) of participants reported not participating in physical activity and 29.1% (97) had a body mass index of 25 and above. Conclusions The outcome of this study suggests that there's a need for structured educational programs in schools and public health campaigns. The general public must have a reliable source of information rather than the mass media and false information read from social media.
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Affiliation(s)
- Eman Elsheikh
- Department of Cardiology, College of Medicine, Tanta University Hospital, Tanta, EGY
- Department of Internal Medicine, College of Medicine, King Faisal University, Al-Ahsa, SAU
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Rahimi T, Morowatisharifabad MA, Farajkhoda T, Fallahzadeh H. A comprehensive health-promoting neighborhood intervention to improve health care seeking behavior among reproductive age Iranian women. BMC Womens Health 2023; 23:171. [PMID: 37041521 PMCID: PMC10091519 DOI: 10.1186/s12905-023-02308-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/26/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Women's health care seeking delays remains an unresolved major public health problem in developing and underdeveloped countries. This study aimed to evaluate a health-promoting neighborhood intervention to improve health care seeking behavior (HCSB) among reproductive age Iranian women using Health Promotion Model (HPM). METHOD This randomized controlled trial was conducted on 160 women of reproductive age in two groups: experimental and control. Data were collected by self-administered questionnaire based on HPM constructs and a medical symptom checklist. A health-promoting neighborhood intervention was performed in seven sessions for the experimental group. HCSB and HPM constructs were measured before and 3 months after intervention in the two groups. p < 0.05 was considered significant level. RESULTS The average mean age of participants was 30.45 ± 7.80 years. After intervention, the mean score of self-efficacy, interpersonal influences, commitment to plan and HCSB was increased significantly in women in the experimental group, while negative constructs such as perceived barriers, negative activity-related affect, and immediate competing demands and preferences significantly decreased (p < 0.05). In addition, the mean score of referring for symptoms such as excessive sweating, persistent fatigue or weakness, headache, bleeding or spotting between periods, vaginal itching and irritation, unusual vaginal discharge, flashing, chest pain, rapid heartbeats, aching muscles or joints, urinary problems and some mental disorder was increased significantly in experimental group compared to control group (p < 0.05). CONCLUSIONS The results of study show that an intervention based on the HPM have a positive impact on HCSB and its associated factors and can help improve women's health behaviors and health outcomes.
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Affiliation(s)
- Tahereh Rahimi
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Tahmineh Farajkhoda
- Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Center for Healthcare Data Modeling, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Petrova D, Pollán M, Garcia-Retamero R, Rodríguez-Barranco M, Catena A, Castillo Portellano L, Sánchez MJ. Cancer awareness in older adults: Results from the Spanish Onco-barometer cross-sectional survey. Int J Nurs Stud 2023; 140:104466. [PMID: 36871541 DOI: 10.1016/j.ijnurstu.2023.104466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND About half of all cancers are diagnosed in adults older than 65, making them the age group at highest risk of developing this disease. Nurses from different specialties can support individuals and communities in the prevention and early detection of cancer and should be aware of the common knowledge gaps and perceived barriers among older adults. OBJECTIVES The goal of the current research was to investigate personal characteristics, perceived barriers, and beliefs related to cancer awareness in older adults, with a special focus on perceptions about the influence of cancer risk factors, knowledge of cancer symptoms, and anticipated help-seeking. DESIGN Descriptive cross-sectional study. PARTICIPANTS Participants were 1213 older adults (≥65 years old) from the representative national Onco-barometer survey conducted in 2020 in Spain. METHODS Questions on the perceived influence of cancer risk factors, knowledge of cancer symptoms, and the Spanish version of the Awareness and Beliefs about Cancer (ABC) questionnaire were administered in computer-assisted telephone interviews. RESULTS Knowledge of cancer risk factors and symptoms was strongly related to personal characteristics and was limited among males and older individuals. Respondents from lower socio-economic background recognized fewer cancer symptoms. Having personal or family history of cancer had opposite effects on cancer awareness: It was related to more accurate symptom knowledge but also to lower perceptions about the influence of risk factors and more delayed help-seeking. Anticipated help-seeking times were strongly influenced by perceived barriers to help-seeking and beliefs about cancer. Worry about wasting the doctor's time (48% increase, 95% CI [25%-75%]), about what the doctor might find (21% increase [3%-43%]) and not having enough time to go to the doctor (30% increase [5%-60%]) were related to more delayed help-seeking intentions. In contrast, beliefs that reflected higher perceived seriousness of a potential cancer diagnosis were related to shorter anticipated help-seeking times (19% decrease [5%-33%]). CONCLUSIONS These results suggest that older adults could benefit from interventions informing them about how to reduce their cancer risk and addressing emotional barriers and beliefs associated with help-seeking delays. Nurses can contribute to educating this vulnerable group and are in a unique position to address some barriers to help-seeking. STUDY REGISTRATION Not registered.
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Affiliation(s)
- Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Marina Pollán
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; National Center for Epidemiology, Health Institute Carlos III, Madrid, Spain
| | | | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Lucia Castillo Portellano
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; University Hospital Virgen de las Nieves, Granada, Spain
| | - Maria-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Hazar S, Güleç Şatir D. The effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women. Women Health 2023; 63:125-133. [PMID: 36581448 DOI: 10.1080/03630242.2022.2162190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study was carried out to determine the effect of fear of COVID-19 on health-seeking behaviors and Pap smear test rates in women. This study was conducted online between June and September 2021. Women aged 21-65 years were invited to participate in the study via social media. A total of 396 women comprised the sample for this study. Data were collected the Fear of COVID-19 Scale, and the Health-seeking Behavior Scale. Data were evaluated using descriptive statistics, parametric tests and regression analysis. As a result of the study, 11.1 percent of women were found to have had a Pap smear test during the pandemic period. Fear of COVID-19 was determined to have a positive and significant effect on online health-seeking behavior (t = 7.915, p < .001), professional health-seeking behavior (t = 4.503, p < .001), traditional health-seeking behavior (t = 6.037, p < .001), and general health-seeking behavior(t = 8.390, p < .001) while it did not have any effect on having a Pap smear test (p > .05). This study showed that although the fear of COVID-19 positively affected health-seeking behaviors in women, the rates of gynecological examination and Pap smear test rates were low during the pandemic.
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Affiliation(s)
- Seda Hazar
- Department of Birth and Women Health and Diseases Nursing, Inonu University Faculty of Nursing, Malatya, Turkey
| | - Duygu Güleç Şatir
- Department of Women Health and Diseases Nursing, Ege University Faculty of Nursing, Ege University School of Nursing, Izmir, Turkey
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Factors Involved in Nurses' Health-Seeking Behaviors: A Qualitative Study. ANS Adv Nurs Sci 2023; 46:E1-E15. [PMID: 36066331 DOI: 10.1097/ans.0000000000000447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study aimed to explore the factors involved in Iranian nurses' health-seeking behavior. In this qualitative exploratory descriptive study, 15 nurses from hospitals affiliated to Iran and Qazvin University of Medical Sciences were interviewed from April to March 2020. Data were collected via purposive sampling by unstructured in-depth interviews and analyzed using thematic analysis. Findings identified 5 main themes, "fear," "trust/distrust," "excuse," "accessibility," and "support" that were involved in nurses' health-seeking behavior. The findings of this study may contribute to a deeper understanding of the factors involved in nurses' health-seeking behavior and pave the way for further research and policy making regarding nursing workforce health.
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Birkás B, Kiss B, Coelho CM, Zsidó AN. The role of self-reported fear and disgust in the activation of behavioral harm avoidance related to medical settings. Front Psychiatry 2023; 14:1074370. [PMID: 36761866 PMCID: PMC9902716 DOI: 10.3389/fpsyt.2023.1074370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/03/2023] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Although adaptive defense mechanisms are useful in helping us avoid getting injured, they are also triggered by medical interventions and procedures, when avoidance is harmful. A body of previous results showed that both fear and disgust play a pivotal role in medical avoidance. However, the underlying mechanisms are not fully understood. Thus, the aim of the current study was to examine the effects of experience, perceived control, and pain on medical avoidance with disgust and fear as mediating factors from an evolutionary perspective. METHODS We assessed participants' knowledge of and experience with medical procedures, former negative medical experiences, and health-related information; their life history strategy variation; pain-related fear and anxiety of medical procedures; perceived control over emotional reactions and extreme threats; disgust sensitivity; blood-injury-injection phobia and medical treatment avoidance. RESULTS We found that more knowledge, experience, and a slower life strategy were linked to a greater level of perceived control and attenuated emotional reactions. Further, better ability to control affective and stress reactions to negative experiences was linked to reduced disgust and fear of pain, and thus might mitigate the level of perceived threat, and diminish fear and disgust reactions. DISCUSSION More knowledge and experiences, better perceived control together with reduced disgust and fear of pain can decrease the probability of avoiding medical situations. Implications to treatment are discussed. Results support the importance of targeting these contextual factors in prevention to increase the likelihood of people attending regular screenings or seeking medical care when needed.
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Affiliation(s)
- Béla Birkás
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Botond Kiss
- Faculty of Human and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Carlos M Coelho
- Department of Psychology, Faculty of Human and Social Sciences, Azores University, Ponta Delgada, Portugal.,Center for Psychology, Porto University, Porto, Portugal
| | - András N Zsidó
- Faculty of Human and Social Sciences, Institute of Psychology, University of Pécs, Pécs, Hungary.,Szentagothai Research Centre, University of Pécs, Pécs, Hungary
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Yang Y, Zhang Y, Ren L. Prognosis Analysis of Delayed Call Time for Chest Pain in Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Direct Percutaneous Coronary Intervention. Clin Appl Thromb Hemost 2023; 29:10760296231186811. [PMID: 37533332 PMCID: PMC10399249 DOI: 10.1177/10760296231186811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 08/04/2023] Open
Abstract
To describe the impact of delayed call time for chest pain in the salvage of ST-segment elevation myocardial infarction (STEMI) patients and its associated independent risk factors, and to identify risk factors associated with cumulative morbidity and mortality in STEMI patients at 4 years after percutaneous coronary intervention (PCI). Retrospective analysis of 398 patients diagnosed with STEMI and treated with emergency PCI within 24 hours of symptom onset in Fuyang People's Hospital from April 2018 to April 2021. The enrolled patients were divided into ≤60 minutes group (193 cases), and > 60 minutes group (205 cases), according to the delayed call time of patients with chest pain. Analysis of basic clinical data, rescue time, and major cardiovascular adverse events in the 2 groups. Multifactorial logistic regression analysis of independent correlates of delayed chest pain calls and Cox proportional risk regression modeling of risk factors for cumulative morbidity and mortality at 4 years after surgery. Compared to the delayed call time ≤ 60 minutes group, the > 60 minutes group had a higher proportion of females, a history of diabetes, rural remote areas, and farmer occupation (P < .05). Binary logistic regression analysis shows the history of diabetes and female as independent risk factors for delayed call time >60 minutes for chest pain. In the delayed call time ≤60 minutes group, the time from symptom onset-to-balloon (S0-to-B) and from symptom onset-to-first medical contact (SO-to-FMC) were smaller than in the delayed call time >60 minutes group (P < .05). The sum of postinfarction angina and major cardiovascular adverse events was lower in the group with delayed call time ≤60 minutes than in the group with delayed call time >60 minutes (P < .05). The Kaplan-Meier survival curve and the survival curve without the occurrence of major adverse cardiovascular events were statistically significant in both groups (P < .05). Multifactorial Cox regression analysis showed that delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III were all risk factors for cumulative morbidity and mortality at 4 years after PCI in patients with STEMI. Delayed call time for chest pain >60 minutes, left main + 3 branch lesions, and cardiac function Killip ≥ III are all risk factors for cumulative morbidity and mortality in STEMI patients at 4 years after PCI. Reducing the delayed call time for chest pain can improve the long-term prognosis of patients.
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Affiliation(s)
- Yangyang Yang
- Bengbu Medical College, Fuyang People's Hospital Affiliated to Bengbu Medical College, Fuyang, China
| | - Yuanzhuo Zhang
- Bengbu Medical College, Fuyang People's Hospital Affiliated to Bengbu Medical College, Fuyang, China
| | - Lei Ren
- Fuyang People's Hospital Affiliated to Anhui Medical University, Fuyang, China
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Barriers to Early Presentation amongst Rural Residents Experiencing Symptoms of Colorectal Cancer: A Qualitative Interview Study. Cancers (Basel) 2022; 15:cancers15010274. [PMID: 36612270 PMCID: PMC9818976 DOI: 10.3390/cancers15010274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Abstract
Rural cancer inequalities are evident internationally, with rural cancer patients 5% less likely to survive than their urban counterparts. There is evidence to suggest that diagnostic delays prior to entry into secondary care may be contributing to these poorer rural cancer outcomes. This study explores the symptom appraisal and help-seeking decision-making of people experiencing symptoms of colorectal cancer in rural areas of England. Patients were randomly invited from 4 rural practices, serving diverse communities. Semi-structured interviews were undertaken with 40 people who had experienced symptoms of colorectal cancer in the preceding 8 weeks. Four key themes were identified as influential in participants' willingness and timeliness of consultation: a desire to rule out cancer (facilitator of help-seeking); stoicism and self-reliance (barrier to help-seeking); time scarcity (barrier to help-seeking); and GP/patient relationship (barrier or facilitator, depending on perceived strength of the relationship). Self-employed, and "native" rural residents most commonly reported experiencing time scarcity and poor GP/patient relationships as a barrier to (re-)consultation. Targeted, active safety-netting approaches, and increased continuity of care, may be particularly beneficial to expedite timely diagnoses and minimise cancer inequalities for rural populations.
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Kuriakose S, Krishnamurthy A, Vinutha RS, Ramshankar V, Sekhar S, Walia GK, Gupta R, Aggarwal A, Singh R, Rajan S, Kondal D, Grover S, Prabhakaran D, Dhillon PK, Shridhar K, Goodman M. Time intervals and patient-level factors in oral cancer diagnostic pathways: An application of the WHO framework in India. Cancer Epidemiol 2022; 81:102283. [PMID: 36335850 DOI: 10.1016/j.canep.2022.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oral cancer, a leading cancer-site in India, is often detected at advanced stages. We evaluated the time intervals from first symptom to help-seeking and diagnosis among oral cancer patients. METHODOLOGY In this cross-sectional study, we recruited 226 consecutive oral cancer patients (mean age ( ± SD) 51.9 years ( ± 10.9); 81.9% men; 70.3% advanced stage) registered for diagnosis and treatment, between 2019 and 2021 at a cancer care centre in South India. We used WHO framework and previously standardized tools to record time intervals (appraisal, help-seeking and diagnostic) and baseline characteristics. We utilized multivariable logistic regression models to test the associations between 'prolonged (i.e., over 1 month) time intervals') and patient-level factors to estimate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Over a half of patients presented with prolonged appraisal (60%) and help-seeking intervals (57%), and a third (34%) reported prolonged diagnostic interval. Patients with no formal education, no routine healthcare visits, no self-reported risk factors, and those who did not perceive initial symptoms to be serious were 2-4 times more likely to have prolonged appraisal and help-seeking than the rest. High travel costs and self-decision for visiting healthcare facility prolonged help-seeking. Diagnostic interval was prolonged only among women OR= 2.7 (95% CI: 1.2-6.1)) and in patients whose first doctor's opinion was 'nothing to worry' OR (=7.3 (95% CI: 2.6-20.5)). 'Correct knowledge of cancer' shortened appraisal and help-seeking intervals and 'incorrect knowledge and negative beliefs' prolonged diagnostic interval. CONCLUSION Our findings highlight that interventions targeting sociocultural and economic determinants, symptom awareness, sensitizing persons at risk (especially women) and primary care providers might reduce overall time to diagnosis. Further, patients without any known risk factors for oral cancer might be at-risk for prolonged appraisal interval. These might help inform 'pull' strategies for cancer control in India and similar settings.
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Affiliation(s)
- Steena Kuriakose
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India.
| | | | - R S Vinutha
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Vijayalakshmi Ramshankar
- Department of Preventive Oncology and Molecular Testing Laboratory, Cancer Institute WIA, Adyar, Chennai 600020, India.
| | | | - Gagandeep Kaur Walia
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Ruby Gupta
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Aastha Aggarwal
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Ranjana Singh
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Sheril Rajan
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India.
| | - Dimple Kondal
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Surbhi Grover
- Hospital of the University of Pennsylvania, Department of Radiation Oncology, 3400 Civic Center Blvd., Philadelphia, PA 19104, United States.
| | - D Prabhakaran
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Preet K Dhillon
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Department of Real World Data, PD Data Sciences, Genentech Inc., South San Francisco, CA, USA.
| | - Krithiga Shridhar
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Michael Goodman
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States.
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A cross-sectional survey of self-medication with Traditional Chinese Medicine for treatment and prevention of COVID-19. Complement Ther Med 2022; 71:102898. [PMID: 36372316 PMCID: PMC9650265 DOI: 10.1016/j.ctim.2022.102898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate user behavioural profiles and the prevalence of self-medication with traditional Chinese medicine (TCM) for COVID-19 among the general public in China. DESIGN Cross-sectional study. SETTING Self-administered online survey was carried out between January and June 2021 in China. RESULTS A total of 1132 complete responses were received from a nationwide sample. A considerable proportion viewed TCM to be more effective than Western medicine for treating COVID-19 (67.1 %) and stated that it is safer to use TCM (63.5 %) and easier to access TCM for treating COVID-19 (63.5 %). A total of 16.4 % (95 %CI 14.3-18.7) reported ever self-medicating with TCM to resolve COVID-19 symptoms and 12.2 % (95 % CI 10.3-14.2) ever using TCM to prevent SARS-CoV-2 infection. Lianhua Qingwen capsule/granule (53.2 %), Ganmao granule (50.5 %) and Banlangen granule (44.6 %) were most commonly used to resolve COVID-19 symptoms whereas Banlangen granule (60.1 %) was commonly used for the prevention of SARS-CoV-2 infection. Older age participants, from rural areas, with chronic diseases, higher socioeconomic status, and a positive attitude towards TCM were more likely to self-medicate using TCM to resolve COVID-19 symptoms. CONCLUSION Self-medication with TCM during the COVID-19 pandemic for symptom control or prevention is prevalent. The findings of the user behavioural profile and types of TMCs commonly used in this study provide beneficial information for the development of strategies to improve public health-seeking behaviour and the performance of the country's healthcare system in the era of the COVID-19 pandemic.
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Bongaerts THG, Büchner FL, Crone MR, van Exel J, Guicherit OR, Numans ME, Nierkens V. Perspectives on cancer screening participation in a highly urbanized region: a Q-methodology study in The Hague, the Netherlands. BMC Public Health 2022; 22:1925. [PMID: 36243684 PMCID: PMC9571478 DOI: 10.1186/s12889-022-14312-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Netherlands hosts, as many other European countries, three population-based cancer screening programmes (CSPs). The overall uptake among these CSPs is high, but has decreased over recent years. Especially in highly urbanized regions the uptake rates tend to fall below the minimal effective rate of 70% set by the World Health Organization. Understanding the reasons underlying the decision of citizens to partake in a CPS are essential in order to optimize the current screening participation rates. The aim of this study was to explore the various perspectives concerning cancer screening among inhabitants of The Hague, a highly urbanized region of the Netherlands. METHODS A Q-methodology study was conducted to provide insight in the prevailing perspectives on partaking in CSPs. All respondents were inhabitants of the city of The Hague, the Netherlands. In an online application they ranked a set of 31 statements, based on the current available literature and clustered by the Integrated Change model, into a 9-column forced ranking grid according to level of agreement, followed by a short survey. Respondents were asked to participate in a subsequent interview to explain their ranking. By-person factor analysis was used to identify distinct perspectives, which were interpreted using data from the rankings and interviews. RESULTS Three distinct perspectives were identified: 1). "Positive about participation", 2). "Thoughtful about participation", and 3). "Fear drives participation". These perspectives provide insight into how potential respondents, living in an urbanized region in the Netherlands, decide upon partaking in CSPs. CONCLUSIONS Since CSPs will only be effective when participation rates are sufficiently high, it is essential to have insight into the different perspectives among potential respondents concerning partaking in a CSP. This study adds new insights concerning these perspectives and suggests several ideas for future optimization of the CSPs.
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Affiliation(s)
- Thomas H G Bongaerts
- Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands. .,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Frederike L Büchner
- Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Matty R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.,Erasmus Centre for Health Economics Research, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Onno R Guicherit
- University Cancer Center Leiden - The Hague, at Haaglanden Medical Center, The Hague, The Netherlands
| | - Mattijs E Numans
- Health Campus The Hague, Leiden University Medical Center, The Hague, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Vera Nierkens
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Lodhia J, Goodluck G, Tendai J, Urassa E, Nkya G, Mremi A. Case series of high-grade soft tissue sarcoma of the lower limb with delayed diagnosis: Experience at a tertiary hospital in northern Tanzania. Int J Surg Case Rep 2022; 97:107475. [PMID: 35932713 PMCID: PMC9403340 DOI: 10.1016/j.ijscr.2022.107475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Soft tissue sarcoma is an uncommon form of cancer with poor prognosis. Early diagnosis and treatment are vital for improving the treatment outcomes. CASE PRESENTATION We report a series of high-grade soft tissue sarcomas of the lower extremity with delayed diagnosis to gain insight into the presentation, treatments and outcomes for this rare disease and to determine whether limb-salvage surgery yields reasonable outcomes. CLINICAL DISCUSSION Timely health seeking has an impact on the outcome of the treatment of any particular disease. Patient delays are usually socio-economic factors. Soft tissues sarcomas are uncommon malignant tumors that even managed adequately have a poor 5-year survival. Limb salvage becomes questionable especially when patients present late with adverse symptoms. CONCLUSION In this series, we found that patients presented late and this led to unfavorable oncological outcomes, also limb salvage was not an option due to delayed presentation. Thus, early diagnosis is recommended so as to improve treatment outcome.
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Affiliation(s)
- Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania,Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania,Corresponding author at: Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania.
| | - Gregory Goodluck
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania
| | - Joylene Tendai
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania
| | - Ellyagape Urassa
- Department of General Surgery, Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania
| | - Gilbert Nkya
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania,Department of Pathology, Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania,Department of Pathology, Kilimanjaro Christian Medical Centre, P. O Box 3010, Moshi, Tanzania
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Sandhu VK, Duro T, Kamboj A, Salto L, Chiruvolu N. Barriers to Enrollment in Rheumatology Research: Who, What, Where, When, and Why? Cureus 2022; 14:e27235. [PMID: 36039219 PMCID: PMC9400834 DOI: 10.7759/cureus.27235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 11/26/2022] Open
Abstract
Despite the evidence that complicated rheumatic diseases are more prevalent and severe in ethnic minorities, rheumatology research is afflicted with inadequate patient representation. It is lacking in ethnic and socioeconomic diversity. The objective of this study is to identify barriers to enrollment in rheumatology research and propose possible solutions to overcome these barriers. In this study, 184 patients from two rheumatology clinics (Safety Net clinic, a university-based clinic) were surveyed for concerns regarding participation in clinical research. Patients were asked to rank their top five of eight concerns. Data were then stratified by self-reported ethnicity and clinic site to determine ranking differences in both groups. Fear of risks associated with clinical research was ranked as the primary barrier in all ethnicities. More non-Hispanic Whites (NHW) (24.4%) ranked work responsibilities as a primary barrier compared to Hispanics (10%). Fear of discovering a serious illness as a primary barrier was more frequent at the Safety Net clinic (25%) compared to the university-based clinic (6.3%) and ranked more frequently in the top five in Hispanics compared to NHW. Fears associated with research risks, work responsibilities, and fear of discovering a serious illness were the top-ranked barriers to enrollment in research among patients. However, differences in rankings between ethnicities and clinic sites were identified. This sheds light on the importance of health literacy and the responsibility of researchers in addressing gaps in communication while acknowledging potential cultural components that warrant further investigation.
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Merten JW, Hamadi HY, King JL. Cancer Risk Perceptions Among People Who Check Their Skin for Skin Cancer: Results from the 2017 U.S. Health Information National Trends Survey (HINTS). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:770-778. [PMID: 32968953 DOI: 10.1007/s13187-020-01880-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
When detected early, melanoma is highly treatable and rarely fatal. Self-skin checks can identify changes in moles that could be an indicator of melanoma. Cancer risk perceptions may influence the uptake of important preventive health behaviors such as self-skin checks. The purpose of this study is to examine cancer risk perception factors associated with those who have checked their skin for signs of skin cancer using the 2017 HINTS data. Retrospective cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having checked skin for signs of skin cancer, risk perceptions, and demographic variables. White women over the age of 45 with a college degree and annual incomes greater than $75,000 were more likely to check their skin for signs of skin cancer. More than a third reported they would rather not know if they had cancer and more than 60% had some level of worry about having cancer. Those with a personal or family history of cancer were more likely to check. HINTS is a cross-sectional survey which provides only a glimpse of behavioral predictors. Self-skin checks are simple and cost-effective to detect melanoma early and improve outcomes. Fear and worry about cancer were significant factors in the likelihood of checking skin for signs of skin cancer. Population-based strategies could be developed to reduce concerns about early detection.
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Affiliation(s)
- Julie Williams Merten
- Department of Public Health, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224, USA.
| | - Hanadi Y Hamadi
- Department of Health Administration, University of North Florida, Jacksonville, FL, USA
| | - Jessica L King
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
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Šantrić Milićević M, Djurin A, Terzić-Šupić Z, Todorović J, Nikolić D, Soldatović I. Knowledge and barriers to early detection of breast cancer among female primary care patients in Serbia. Cent Eur J Public Health 2022; 30:119-130. [PMID: 35876601 DOI: 10.21101/cejph.a6305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/16/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Breast cancer is the leading cause of cancer mortality among women in Serbia and accounts for 22.8% of total cancer mortality in 2018. This study assessed the knowledge and barriers to early detection of breast cancer in women. METHODS In March 2019, at the Primary Healthcare Centre Kikinda, Serbia, a 22-item questionnaire was distributed to a series of patients (N = 403, response rate 91.8%) to assess the odds ratio (OR) and 95% confidence interval (CI) between variables explaining knowledge of breast cancer symptoms and risk factors and barriers to screening, and four types of early detection of breast cancer. RESULTS The majority of patients (85.4%) know that a lump in a breast is a common symptom of breast cancer and that a family history of breast cancer is a risk factor (80.1%); 63.8% of respondents aged ≥ 30 years self-examined their breasts in the past month, 39.1% of patients aged ≥ 40 years had clinical, while 34.4% had ultrasound breast examination in the past year, and 51.1% of patients aged ≥ 50 years had mammography once in the past two years. Patients aged ≥ 40 years retired and those with a positive family history were 84% and 63% less likely not to undergo a clinical breast examination in the past year. Participants over 40 years of age who reported a lack of funds were 2.46 times more likely to miss a clinical breast examination than those who did not have that barrier. Among participants aged 50-69 years, the likelihood of not receiving the mammography increases by 2.82 with an increase in wealth status and it was 65% lower for those who lack information about the available treatment. CONCLUSION Women under the age of 50 rarely practice breast cancer screening. Study findings can be used to improve breast cancer screening at the primary level.
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Affiliation(s)
| | - Ana Djurin
- Primary Healthcare Centre of Kikinda, Kikinda, Serbia
| | - Zorica Terzić-Šupić
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Todorović
- Faculty of Medicine, Institute of Social Medicine, University of Belgrade, Belgrade, Serbia
| | - Dejan Nikolić
- University Children's Hospital, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatović
- Faculty of Medicine, Institute for Statistics and Medical Informatics, University of Belgrade, Belgrade, Serbia
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Association between Self-Medication for Mild Symptoms and Quality of Life among Older Adults in Rural Japan: A Cross-Sectional Study. Medicina (B Aires) 2022; 58:medicina58060701. [PMID: 35743965 PMCID: PMC9227455 DOI: 10.3390/medicina58060701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/12/2022] Open
Abstract
Self-medication, a help-seeking behavior to control individual symptoms, can be promoted to prevent the overuse of medical care and improve self-management among older adults. However, evidence regarding the association between self-medication and quality of life (QOL) is lacking. The purpose of this study is to investigate the association between QOL and the usage of self-medication among rural older adults. This cross-sectional study included participants older than 65 years in rural Japanese communities. Data were collected using a questionnaire regarding self-medication trends, the EQ-5D-5L to assess QOL, and a demographics questionnaire. Participants were divided into exposure and control groups based on their tendencies toward self-medication usage. Differences in the demographics between groups were adjusted using propensity score matching. Results: The health status in the exposure group was statistically significantly better than that in the control group in the dimensions of movement, self-care, and usual activities. Conversely, the pain/discomfort and anxiety/depression dimensions were not statistically significantly different. The quality of self-medication behaviors for mild symptoms can be improved with practical knowledge of and access to home remedies and over-the-counter drugs. Educational interventions and system development for better self-medication for mild symptoms and medical care for critical symptoms in rural contexts can be effective in improving QOL among rural older adults.
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HEALTHCARE DEMAND PROCRASTINATION SCALE: DEVELOPMENT AND VALIDATION STUDY. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1068530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Vejlgaard AS, Rasmussen S, Haastrup PF, Jarbøl DE, Balasubramaniam K. Is concern for gynaecological alarm symptoms associated with healthcare-seeking? A Danish population-based cross-sectional study. BMC Public Health 2022; 22:25. [PMID: 34991531 PMCID: PMC8739714 DOI: 10.1186/s12889-021-12389-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background Diagnosing cancer at an early stage increases survival, and for most gynaecological cancers the diagnostic pathway is initiated, when women seek medical attention with symptoms. As many factors influence healthcare-seeking, knowledge about these factors is important. Concern can act as a barrier or a trigger for women experiencing gynaecological alarm symptoms. This study aimed to examine whether concern for the symptom or the current health was associated with healthcare-seeking among women with gynaecological alarm symptoms. Methods Some 100,000 randomly selected Danish citizens were invited to a national web-based survey. The questionnaire included items regarding symptom experiences, healthcare-seeking and concern for the experienced symptoms and current health. This study included 5019 women with self-reported gynaecological alarm symptoms (pelvic pain, pain during intercourse, bleeding during intercourse and postmenopausal bleeding). Concern was reported on a 5-point Likert scale from ‘not at all’ to ‘extremely’. Data were analysed using multivariate logistic regression models. Results Women who were ‘extremely’ concerned about a gynaecological alarm symptom had two to six times higher odds of reporting healthcare-seeking compared to women who were ‘not at all’ concerned. Symptom concern was associated with higher odds of healthcare-seeking for all four gynaecological alarm symptoms and the odds increased with increasing levels of concern. Additionally, concern for current health was associated with higher odds of healthcare-seeking. Concern for current health as expressed by others was positively associated with healthcare-seeking but had only minor influence on the association between concern for current health and healthcare-seeking. Conclusions Concern for a gynaecological alarm symptom and for current health was positively associated with healthcare-seeking. The results can be used for future informational health campaigns targeting individuals at risk of postponing warranted healthcare-seeking.
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Affiliation(s)
- Anja Schmidt Vejlgaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK5000, Odense C, Denmark
| | - Sanne Rasmussen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK5000, Odense C, Denmark
| | - Peter Fentz Haastrup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK5000, Odense C, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK5000, Odense C, Denmark
| | - Kirubakaran Balasubramaniam
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, DK5000, Odense C, Denmark.
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Lai AYK, Sit SMM, Wu SYD, Wang MP, Wong BYM, Ho SY, Lam TH. Associations of Delay in Doctor Consultation With COVID-19 Related Fear, Attention to Information, and Fact-Checking. Front Public Health 2021; 9:797814. [PMID: 34966717 PMCID: PMC8710678 DOI: 10.3389/fpubh.2021.797814] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Delaying doctor consultation is harmful. Fear of COVID-19 leads to delays in seeking medical care at a time when pandemic information overflows. However, little is known about the role of COVID-19 related fear, attention to information, and fact-checking in such delay. Objective: Under the Hong Kong Jockey Club SMART Family-Link Project, we examined the associations of delay in doctor consultation amidst the pandemic with sociodemographic characteristics, COVID-19 related fear, attention to information, and fact-checking. Methods: We conducted a population-based online cross-sectional survey in May 2020 on Hong Kong Chinese adults. Respondents reported whether the pandemic caused any delay in doctor consultation (yes/no), level of COVID-19 related fear, attention to information and fact-checking (all on a scale of 0 to 10 and recoded into tertiles of low, moderate, high). Regression analyses were used to examine the associations of delay and fear with sociodemographic characteristics, attention and fact-checking, adjusting for covariates. Data were weighted by sex, age and education level of the population. Results: Of 4,551 respondents (46.5% male, 59.7% aged over 45 years), 10.1% reported delay in doctor consultation. The mean score was 6.4 for fear, 8.0 for attention and 7.4 for fact-checking. Delay was more common in males and increased with age and fear. High vs. low level of fear was associated with delay [adjusted odd ratios (AOR) 2.68, 95% confidence interval (CI) 2.08, 3.47]. Moderate level of fact-checking was negatively associated with delay (AOR 0.72, 95% CI 0.56, 0.92). Females reported greater fear and fear decreased with age. Fear increased with attention to information and decreased with fact-checking. Fear substantially mediated the association of delay with attention (96%) and fact-checking (30%). Conclusions: We have first shown that delay in doctor consultation increased with fear of COVID-19 and decreased with fact-checking amidst the pandemic. Fear also increased with attention to COVID-19 related information and decreased with fact-checking. Understanding these associations can help policymakers develop targeted communication and support to the public to reduce delayed doctor consultations and the associated COVID-19-related or unrelated morbidity and mortality in the community.
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Affiliation(s)
- Agnes Yuen-Kwan Lai
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Shirley Man-Man Sit
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Socrates Yong-Da Wu
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Man-Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Bonny Yee-Man Wong
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Potential Help-Seeking Behaviors Associated with Better Self-Rated Health among Rural Older Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179116. [PMID: 34501707 PMCID: PMC8430707 DOI: 10.3390/ijerph18179116] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022]
Abstract
Help-seeking behaviors (HSB) for mild symptoms vary because of differences in health care resources and patients' backgrounds. Potential HSBs for lay and professional care use are related to patients' health conditions. However, there is a lack of evidence of the relation between them. This study examined the relation between patients' potential HSBs and self-rated health (SRH). The cross-sectional study involved 169 patients, aged above 65 years, who visited a Japanese rural clinic. A validated checklist was used to assess potential patients' HSBs. A chi-square test and logistic regression were performed to examine the relation between patients' self-rated health and HSB regarding lay and professional care use. Participants were 77.5 years old, on average (SD = 8.3). Results reveal that having regular exercise habits (OR = 2.42, p = 0.04), adequate sleep (OR = 4.35, p = 0.006), work (OR = 2.59, p = 0.03), high socioeconomic status (OR = 6.67, p = 0.001), and using both lay and professional care (OR = 2.39, p = 0.046) were significantly correlated with high self-rated health. Living alone was negatively correlated with higher SRH (OR = 0.23, p = 0.015). To improve rural patients' health care, in addition to improving their health management skills, potential HSB for mild symptoms should be investigated and interventions that consider patients' socioeconomic factors and living conditions should be implemented.
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Surviving to Acute Myocardial Infarction: The Role of Psychological Factors and Alexithymia in Delayed Time to Searching Care: A Systematic Review. J Clin Med 2021; 10:jcm10173813. [PMID: 34501261 PMCID: PMC8432253 DOI: 10.3390/jcm10173813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/16/2022] Open
Abstract
The time from symptom onset to reperfusion is a critical determinant of myocardial salvage and clinical outcomes in patients with acute myocardial infarction (AMI). This time period could be delayed if people do not seek help promptly and/or if the health system is not efficient in responding quickly and attending to these individuals. The aim of this study was to identify psychological factors associated with pre-hospital delay (PHD) or patients’ decisional delay (PDD) in people with an ongoing AMI. A search in PubMed/Medline from 1990 to 2021 with the keywords “pre-hospital delay” OR “prehospital delay” OR “patient delay” OR “decisional delay” OR “care seeking behavior” AND “psychological factors” OR “alexithymia” AND “myocardial infarction” was performed. Thirty-six studies were included, involving 10.389 patients. Wrong appraisal, interpretation and causal beliefs about symptoms, denial of the severity of the symptoms and high levels of alexithymia were found related to longer PHD or PDD. Alexithymia may be an overarching construct that explains the disparate findings of the studies exploring the role of psychological factors in PHD or PDD. Further studies are needed in order to analyse the role of alexithymia in patients with risk factors for AMI to prevent delay.
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The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168857. [PMID: 34444606 PMCID: PMC8394535 DOI: 10.3390/ijerph18168857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/12/2021] [Accepted: 08/19/2021] [Indexed: 01/18/2023]
Abstract
Maintaining people’s health based on their help-seeking behavior (HSB) regarding mild symptoms is essential. An effective HSB, especially self-management, can facilitate the attainment of appropriate healthcare resources and affect health outcomes such as quality of life (QOL). However, clear evidence regarding the relationship between self-management, mild symptoms, and QOL is unavailable. Therefore, this cross-sectional study investigated this association in a rural elderly population. The participants, aged over 65 years, were living in rural communities. The primary outcome of QOL was examined using the EuroQol 5-Dimension 5-Level (EQ-5D-5L). After adjusting for propensity score matching, 298 participants in the self-management usage group were matched with 298 in the group not using self-management. The most frequent HSB trend was consulting with primary care physicians, followed by self-care, consulting with families, utilizing home medicines, and buying medicines. The EQ-5D-5L scores were statistically higher in the self-management usage group than in the other group. The HSBs with a trend of using self-management were related to a high QOL. Self-management of symptoms along with other HSBs can improve elderly HSBs in rural contexts. Educational interventions and system development for HSBs in rural contexts could be effective in enhancing the QOL of rural elderly populations.
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Monzani D, Pancani L, Rusconi P, Pravettoni G. Perceived Onset Time of Medical Conditions: The Interplay Between Subjective Fear and Risk in Four Lifestyle Domains. Psychol Rep 2021; 125:2981-3005. [PMID: 34324370 DOI: 10.1177/00332941211036028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Engaging in unhealthy behaviors (e.g., smoking, drinking) and not engaging in healthy ones (e.g., exercising, consuming fruit and vegetables) are both relatively prevalent among individuals despite the available information about their risks for health. People's perception of an event's time course can be used to gauge their risk perception for that event thus casting light on any possible misperception and suggesting directions for health-promoting interventions. This study investigates people's perception of the time of onset of 5 noncommunicable diseases (e.g., "having high blood pressure") associated with 4 health-related behaviors: Smoking, drinking, exercising, and eating fruit and vegetable. Participants from Italy (N = 214) and the UK (N = 151) gave onset time estimates of how long they thought it would take for 5 noncommunicable diseases to occur in the life of an 18-year-old person who starts or stops adopting those health-related behaviors. Results showed that participants who rated the noncommunicable diseases as more likely to themselves perceived the onset time of these diseases as more temporally proximal. Participants who were more afraid of developing the noncommunicable diseases estimated their onset time as delayed.
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Affiliation(s)
- Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Luca Pancani
- Department of Psychology, University of Milano - Bicocca, Italy
| | - Patrice Rusconi
- School of Psychology, University of Surrey, UK; Department of Cognitive Sciences, Psychology, Education and Cultural Studies, 18980University of Messina, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Italy; Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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Birkás B, Csathó Á, Teleki S, Zsidó A. Confirming the factor structure and improving the screening function of the Medical Fear Survey - short in a Hungarian community sample. ANXIETY STRESS AND COPING 2021; 35:248-258. [PMID: 33853454 DOI: 10.1080/10615806.2021.1913490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Medical Fear Survey (MFS) was designed to assess the fear of medical treatments and related factors through five dimensions including fears of injections and blood draws, sharp objects, blood, mutilation, medical examination and physical symptoms. We analysed the factor structure and validity of a short version of MFS in Hungarian, on a large sample (2631 participants; 558 men, 2067 women) focusing on possible age and gender differences (aged Mean = 30.4, SD = 13.4), which were not reported for the original version. Furthermore, using discriminant analysis, potential screening function of the MFS-short was examined. Results supported construct and convergent validity and scale-reliability for the five-factor structure of the MFS-short. Further analyses demonstrated excellent discriminatory power for four subscales, while one subscale had acceptable power. Our findings provide implications for the utility of MFS-short as a screening measure in assessing the severity of medical fears controlling for gender differences and age-biases.
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Affiliation(s)
- Béla Birkás
- Institute of Behavioral Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Árpád Csathó
- Institute of Behavioral Sciences, Medical School, University of Pécs, Pécs, Hungary
| | | | - András Zsidó
- Institute of Psychology, University of Pécs, Pécs, Hungary
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29
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Carter W, Bick D, Mackintosh N, Sandall J. Maternal help seeking about early warning signs and symptoms of pre-eclampsia: A qualitative study of experiences of women and their families. Midwifery 2021; 98:102992. [PMID: 33780789 DOI: 10.1016/j.midw.2021.102992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 02/06/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Pre-eclampsia is a disorder of pregnancy, where delay in diagnosis and management of warning signs and symptoms can lead to serious morbidity and mortality for women and their infants. AIM The aim of this study was to understand factors that influenced women's help seeking in response to the onset of early warning signs and symptoms of pre-eclampsia as well as partners or family members' ability to raise their health concerns with healthcare professionals during the progression of the disorder. DESIGN AND METHODS A qualitative narrative research design was used. In depth interviews were used to explore the experiences of 23 women who experienced pre-eclampsia and their families in an urban setting in the UK. Purposive heterogeneity sampling was used to select participants. RESULTS Themes associated with help-seeking amongst women included: 1) Risk assessment, 2) Self-monitoring, 3) Organisational constraints. Women categorised as at low risk of hypertensive disorders at their antenatal booking appointment reported a lack of information on pre-eclampsia which affected their ability to seek help as they were unaware of signs and symptoms of the onset of the condition. In contrast women categorised as high risk at this initial appointment considered they were offered too much information about onset of pre-eclampsia, although this facilitated help seeking as they were much more able to recognise signs and symptoms of onset and knew who to contact. Of note is that some women did not experience 'classic' signs and symptoms of pre-eclampsia or were unable to distinguish these from normal signs and symptoms of pregnancy. Some women used self-monitoring, mainly self-initiated and self-taught, of their own blood pressure in order to a) negotiate access to treatment and b) to self-discharge from hospital postnatally. CONCLUSION Women and their families need individualised information on signs and symptoms of pre-eclampsia to facilitate timely and appropriate help seeking. Women often used self-monitoring of their blood-pressure to negotiate for help.
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Affiliation(s)
- Wendy Carter
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences and Medicine, SE1 7EH, King's College London, UK.
| | - Debra Bick
- University of Warwick, Warwick Clinical Trials Unit, University Road, Coventry CV4 7AL, UK.
| | - Nicola Mackintosh
- Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, LE1 7RH, UK.
| | - Jane Sandall
- Department of Women and Children's Health, School of Life Course Science, Faculty of Life Sciences and Medicine, SE1 7EH, King's College London, UK.
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Labisso WL, Leka Y, Leka Y, Haileselassie W. A Descriptive Cross-Sectional Study on Awareness and Belief of People About Cancer in Southern Ethiopia: Special Focus on Breast and Cervical Cancers. Risk Manag Healthc Policy 2020; 13:2655-2668. [PMID: 33239927 PMCID: PMC7682616 DOI: 10.2147/rmhp.s267207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The general population's lack of awareness, limited knowledge, myths and misconceptions about breast and cervical cancers (CCs) is considered as a serious public health problem. OBJECTIVE This study was intended to assess the status of awareness and beliefs of people about cancer and breast and CCs in particular. METHODS A descriptive community-based cross-sectional survey was conducted on 345 study participants in Southern Ethiopia. A pretested, structured questionnaire that contained demographics and questions on the variables of exposure to biological and chemical carcinogenic agents, lifestyle and personal behavior was administered. Frequency distribution and proportions were used to describe the study population in relation to major variables. RESULTS The mean age of study participants was 25.19 (Range 15-58). More than a third of the study participants heard about cancer from Mass Media followed by schools (28.5%) and treating physicians (6.7%). The proportion of study participants that knew about the association between smoking, alcohol intake and cancer development was 38.6% and 51.5%, respectively. Only 48% and 24.2% of the study participants heard about breast and CCs, respectively. The fact that 69.4% of the study participants had limited knowledge about the mode of transmission of the causative agents of CCs indicates that the study groups are at risk of acquiring the agent. Additionally, only 4.7% of the study participants were screened for CC and have poor breast self-examination experiences, indicating poor awareness and knowledge about the importance of screening programs. CONCLUSION Comprehensive awareness and knowledge about cancer in general and breast and CCs in particular is lacking in southern Ethiopia. Early sexual debut, limited knowledge about the diseases and unfavorable lifestyle are the risk factors to be addressed in public health education.
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Affiliation(s)
- Wajana Lako Labisso
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yishak Leka
- Department of Pathology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Yohannes Leka
- Department of Medical Microbiology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Werissaw Haileselassie
- Department of Reproductive Health and Health Service Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Missing Diagnosis, Pain, and Loss of Function in Older Adults with Rheumatoid Arthritis and Insufficiency Fractures: A Qualitative Study of the Patient's Perspective. Geriatrics (Basel) 2020; 5:geriatrics5040094. [PMID: 33213075 PMCID: PMC7709668 DOI: 10.3390/geriatrics5040094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022] Open
Abstract
Rheumatoid arthritis (RA) is characterised by a chronic, progressive inflammation in the joints and leads to substantial pain, disability, and other morbidities. Few studies document the occurrence of insufficiency fractures, but no studies document the patient's perspective on incurring an insufficiency fracture. The aim of this qualitative study was to explore the patients' perspective on how insufficiency fractures influence their level of activity and to detect their need for rehabilitation. Two focus-group interviews were performed with 10 patients diagnosed with RA and insufficiency fractures. The data from the focus-group interviews were subjected to thematic analysis to provide a sense of the important themes. The 10 patients were all females, aged 57-88 years. Magnetic resonance imaging were performed at a mean of six months and seven days. All patients identified the delayed diagnosis of fracture as a significant burden. They experienced pain but did not receive a diagnosis. When the patients were immobilised, some of them were offered aids such as crutches, which they were unable to use due to their RA. The patients needed a focus on diagnosis and individually customised rehabilitation, taking into account RA and including guidance concerning daily activities, aids, and the regain of physical function.
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32
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Starnoni M, De Santis G, Lolli F, Pinelli M. Factors related to delayed treatment: A case report of a huge cutaneous horn and review of the literature. Ann Med Surg (Lond) 2020; 60:384-388. [PMID: 33235713 PMCID: PMC7670244 DOI: 10.1016/j.amsu.2020.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 11/17/2022] Open
Abstract
We present a case of a man with a giant cutaneous horn over his frontal region. This case has been presented for the size of the lesion, due to delayed treatment, and to illustrate the reasons why the growth of this lesion has been possible in a western country, in the 21st century. It was a solitary, not painful lesion which caused significant aesthetic problems. The diagnosis was based on an ultrasonographic study and the treatment of choice was a surgical excision. This case is an opportunity to review the literature about the cutaneous horns, to talk about the main causes of delayed diagnosis and treatment of cutaneous lesions and, to define the role of the specialist in the assessment of emotions and patient support.
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Affiliation(s)
- Marta Starnoni
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Giorgio De Santis
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Francesca Lolli
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
| | - Massimo Pinelli
- Department of Medical and Surgical Sciences, Division of Plastic Surgery, University of Modena and Reggio Emilia, Policlinico of Modena, Largo Pozzo 71, 41124, Modena, Italy
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33
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Niu L, Liu Y, Wang X, Li H, Chen J, Sriplung H. The Effect of Migration Duration on Treatment Delay Among Rural-to-Urban Migrants After the Integration of Urban and Rural Health Insurance in China: A Cross-Sectional Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2020; 57:46958020919288. [PMID: 32452740 PMCID: PMC7252362 DOI: 10.1177/0046958020919288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Few researches have been focused on the treatment delay of rural-to-urban migrants in China. Our study aimed to investigate the effect of migration duration on treatment delay among rural-to-urban migrants in tertiary hospitals. A cross-sectional study was conducted based on a sample of 727 patients and surveyed factors including sociodemographics, medical costs, migration, treatment delay, and health cost-coping strategies. Totally, 727 patients were included, of which 61 delayed their treatment and 666 had no treatment delay. Statistically significant differences were found between different migration duration groups in marital status, education, insurance, family annual income, residency, payment before treatment, reported disease, and migration duration (P < .05). The results from multiple logistic regression showed that migration between 1 and 5 years (adjusted odds ratio [OR] = 7.24; 95% confidence interval [CI] = 1.59-32.87; P < .05) was considered the significant contributing risk factor for treatment delay after adjusting for age, sex, and other variables. To cope with their health expenditure, patients with treatment delay tended to use less savings and borrow more money than those without. Rural-to-urban migrants with 1 to 5 years of migration were the most vulnerable group of having treatment delay. Migrants were more likely to borrow money to cope with the health expenditure. Targeted services should be provided to meet different needs of migrants according to migration duration.
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Affiliation(s)
- Li Niu
- Jiujiang University, China.,Prince of Songkla University, Hat Yai, Thailand
| | | | | | - Hui Li
- Jiujiang First People's Hospital, China
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34
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Ong CWM, Migliori GB, Raviglione M, MacGregor-Skinner G, Sotgiu G, Alffenaar JW, Tiberi S, Adlhoch C, Alonzi T, Archuleta S, Brusin S, Cambau E, Capobianchi MR, Castilletti C, Centis R, Cirillo DM, D'Ambrosio L, Delogu G, Esposito SMR, Figueroa J, Friedland JS, Ho BCH, Ippolito G, Jankovic M, Kim HY, Rosales Klintz S, Ködmön C, Lalle E, Leo YS, Leung CC, Märtson AG, Melazzini MG, Najafi Fard S, Penttinen P, Petrone L, Petruccioli E, Pontali E, Saderi L, Santin M, Spanevello A, van Crevel R, van der Werf MJ, Visca D, Viveiros M, Zellweger JP, Zumla A, Goletti D. Epidemic and pandemic viral infections: impact on tuberculosis and the lung: A consensus by the World Association for Infectious Diseases and Immunological Disorders (WAidid), Global Tuberculosis Network (GTN), and members of the European Society of Clinical Microbiology and Infectious Diseases Study Group for Mycobacterial Infections (ESGMYC). Eur Respir J 2020; 56:2001727. [PMID: 32586885 PMCID: PMC7527651 DOI: 10.1183/13993003.01727-2020] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/12/2020] [Indexed: 01/08/2023]
Abstract
Major epidemics, including some that qualify as pandemics, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), HIV, influenza A (H1N1)pdm/09 and most recently COVID-19, affect the lung. Tuberculosis (TB) remains the top infectious disease killer, but apart from syndemic TB/HIV little is known regarding the interaction of viral epidemics and pandemics with TB. The aim of this consensus-based document is to describe the effects of viral infections resulting in epidemics and pandemics that affect the lung (MERS, SARS, HIV, influenza A (H1N1)pdm/09 and COVID-19) and their interactions with TB. A search of the scientific literature was performed. A writing committee of international experts including the European Centre for Disease Prevention and Control Public Health Emergency (ECDC PHE) team, the World Association for Infectious Diseases and Immunological Disorders (WAidid), the Global Tuberculosis Network (GTN), and members of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Mycobacterial Infections (ESGMYC) was established. Consensus was achieved after multiple rounds of revisions between the writing committee and a larger expert group. A Delphi process involving the core group of authors (excluding the ECDC PHE team) identified the areas requiring review/consensus, followed by a second round to refine the definitive consensus elements. The epidemiology and immunology of these viral infections and their interactions with TB are discussed with implications for diagnosis, treatment and prevention of airborne infections (infection control, viral containment and workplace safety). This consensus document represents a rapid and comprehensive summary on what is known on the topic.
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Affiliation(s)
- Catherine Wei Min Ong
- Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
- These authors contributed equally
- Members of ESGMYC
| | - Giovanni Battista Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
- These authors contributed equally
| | - Mario Raviglione
- Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy
- Global Studies Institute, University of Geneva, Geneva, Switzerland
| | | | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Jan-Willem Alffenaar
- Sydney Pharmacy School, University of Sydney, Sydney, Australia
- Westmead Hospital, Sydney, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
- Members of ESGMYC
| | - Simon Tiberi
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Division of Infection, Royal London Hospital, Barts Health NHS Trust, London, UK
- Members of ESGMYC
| | - Cornelia Adlhoch
- Public Health Emergency Team, European Centre for Disease Prevention and Control, Stockholm, Sweden
- European Centre for Disease Prevention and Control Public Health Emergency team co-authors
| | - Tonino Alonzi
- Translational Research Unit, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Sophia Archuleta
- Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sergio Brusin
- Public Health Emergency Team, European Centre for Disease Prevention and Control, Stockholm, Sweden
- European Centre for Disease Prevention and Control Public Health Emergency team co-authors
| | - Emmanuelle Cambau
- AP-HP-Lariboisiere, Bacteriologie, Laboratory Associated to the National Reference Centre for Mycobacteria, IAME UMR1137, INSERM, University of Paris, Paris, France
- Members of ESGMYC
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Concetta Castilletti
- Laboratory of Virology, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Rosella Centis
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Daniela M Cirillo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Members of ESGMYC
| | | | - Giovanni Delogu
- Università Cattolica Sacro Cuore, Roma, Italy
- Mater Olbia Hospital, Olbia, Italy
- Members of ESGMYC
| | - Susanna M R Esposito
- Pediatric Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | | | - Jon S Friedland
- St George's, University of London, London, UK
- Members of ESGMYC
| | - Benjamin Choon Heng Ho
- Tuberculosis Control Unit, Dept of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore
| | - Giuseppe Ippolito
- Scientific Direction, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Mateja Jankovic
- School of Medicine, University of Zagreb and Clinic for Respiratory Diseases, University Hospital Center Zagreb, Zagreb, Croatia
- Members of ESGMYC
| | - Hannah Yejin Kim
- Sydney Pharmacy School, University of Sydney, Sydney, Australia
- Westmead Hospital, Sydney, Australia
- Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Senia Rosales Klintz
- Public Health Emergency Team, European Centre for Disease Prevention and Control, Stockholm, Sweden
- European Centre for Disease Prevention and Control Public Health Emergency team co-authors
| | - Csaba Ködmön
- Public Health Emergency Team, European Centre for Disease Prevention and Control, Stockholm, Sweden
- European Centre for Disease Prevention and Control Public Health Emergency team co-authors
| | - Eleonora Lalle
- Laboratory of Virology, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Yee Sin Leo
- National Centre for Infectious Diseases, Singapore
| | - Chi-Chiu Leung
- Hong Kong Tuberculosis, Chest and Heart Diseases Association, Wanchai, Hong Kong, China
| | - Anne-Grete Märtson
- Dept of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Saeid Najafi Fard
- Translational Research Unit, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Pasi Penttinen
- Public Health Emergency Team, European Centre for Disease Prevention and Control, Stockholm, Sweden
- European Centre for Disease Prevention and Control Public Health Emergency team co-authors
| | - Linda Petrone
- Translational Research Unit, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - Elisa Petruccioli
- Translational Research Unit, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | | | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Dept of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Miguel Santin
- Dept of Infectious Diseases, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- Dept of Clinical Science, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
- Members of ESGMYC
| | - Antonio Spanevello
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- Dept of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Reinout van Crevel
- Radboudumc Center for Infectious Diseases, Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands
- Centre for Tropical Medicine and Global Health, Nuffield Dept of Medicine, University of Oxford, Oxford, UK
- Members of ESGMYC
| | - Marieke J van der Werf
- Public Health Emergency Team, European Centre for Disease Prevention and Control, Stockholm, Sweden
- European Centre for Disease Prevention and Control Public Health Emergency team co-authors
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Tradate, Italy
- Dept of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como, Italy
| | - Miguel Viveiros
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine, NOVA University of Lisbon, Lisbon, Portugal
- Members of ESGMYC
| | | | - Alimuddin Zumla
- Dept of Infection, Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK
| | - Delia Goletti
- Translational Research Unit, Epidemiology and Preclinical Research Dept, "L. Spallanzani" National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
- Saint Camillus International University of Health and Medical Sciences, Rome, Italy
- Members of ESGMYC
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Fitch MI, Nicoll I, Lockwood G. Exploring the reasons cancer survivors do not seek help for their concerns: a descriptive content analysis. BMJ Support Palliat Care 2020:bmjspcare-2020-002313. [PMID: 32958504 DOI: 10.1136/bmjspcare-2020-002313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To understand reasons why adult cancer survivors do not seek assistance as they transition from the end of cancer treatment to follow-up care. Understanding these reasons should inform survivorship care, help reduce the burden of suffering and increase quality of life for survivors. METHODS A national survey was conducted in collaboration with ten Canadian provinces to identify unmet needs and experiences with follow-up for cancer survivors between one and 3 years post-treatment. The survey included open-ended questions to allow respondents to add topics of importance and details that offered a deeper insight into their experiences. This publication presents the analysis of the quantitative data and open-ended responses regarding reasons why the adult cancer population does not seek help with their concerns. RESULTS In total, 13 319 respondents answered the question about seeking help. 87% had a physical concern of which 76% did not seek help; 77% had an emotional concern of which 82% did not seek help; and 45% had a practical concern of which 71% did not seek help. Frequently identified reasons for not seeking help included being told it was normal and not thinking anything could be done, not wanting to ask, not thinking services were available, handling it on their own and not thinking it was serious enough to seek help. CONCLUSIONS Survivors have multiple reasons for not seeking help for their concerns. These findings can be useful to healthcare providers in proactively identifying and addressing the needs of these survivors.
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Affiliation(s)
| | - Irene Nicoll
- Independent Consultant, Toronto, Ontario, Canada
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Petrova D, Okan Y, Salamanca-Fernández E, Domínguez-López S, Sánchez MJ, Rodríguez-Barranco M. Psychological factors related to time to help-seeking for cancer symptoms: a meta-analysis across cancer sites. Health Psychol Rev 2020; 14:245-268. [PMID: 31284829 DOI: 10.1080/17437199.2019.1641425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 07/05/2019] [Indexed: 12/19/2022]
Abstract
The time patients wait before seeking help for cancer symptoms is among the most important factors contributing to diagnostic delays in cancer. We reviewed the association between time to help-seeking and three psychological factors: symptom knowledge, symptom interpretation, and beliefs about cancer. Forty-seven studies met the inclusion criteria, providing data from 22 countries concerning seven cancer sites. Better symptom knowledge was related to lower odds of a long help-seeking interval in both studies with healthy populations (OR = .73, 95% CI [.63, .84], k = 19) and patients (OR = .40, 95% CI [.23, .69], k = 12), and so was interpreting experienced symptoms as cancer-related (OR = .52, 95% CI [.36, .75], k = 13 studies with patients). More positive beliefs about cancer (i.e., that cancer is treatable) were associated with lower odds of a long help-seeking interval in both studies with healthy populations (OR = .70, 95% CI [.52, .92], k = 11) and with patients (OR = .51, 95% CI [.32, .82], k = 7). Symptom knowledge, interpretation, and beliefs about cancer are likely to be universal predictors of help-seeking and should be incorporated into theoretical models of patient help-seeking and interventions aiming to reduce delays.
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Affiliation(s)
- Dafina Petrova
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Yasmina Okan
- Centre for Decision Research, Leeds University Business School, University of Leeds, Leeds, UK
| | - Elena Salamanca-Fernández
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - María-José Sánchez
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Cancer Registry of Granada, Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Psychological and cognitive factors related to prehospital delay in acute coronary syndrome: A systematic review. Int J Nurs Stud 2020; 108:103613. [PMID: 32473396 DOI: 10.1016/j.ijnurstu.2020.103613] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical attention after symptoms have started. OBJECTIVE To conduct a systematic review with meta-analysis of the relationship between nine frequently investigated psychological and cognitive factors and prehospital delay. DESIGN A protocol was preregistered in PROSPERO [CRD42018094198] and a systematic review was conducted following PRISMA guidelines. DATA SOURCES The following databases were searched for quantitative articles published between 1997 and 2019: Medline (PubMed), Web of Science, Scopus, Psych Info, PAIS, and Open grey. REVIEW METHODS Study risk of bias was assessed with the NIH Quality Assessment Tool for Observational, Cohort, and Cross-Sectional Studies. A best evidence synthesis was performed to summarize the findings of the included studies. RESULTS Forty-eight articles, reporting on 57 studies from 23 countries met the inclusion criteria. Studies used very diverse definitions of prehospital delay and analytical practices, which precluded meta-analysis. The best evidence synthesis indicated that there was evidence that patients who attributed their symptoms to a cardiac event (n = 37), perceived symptoms as serious (n = 24), or felt anxiety in response to symptoms (n = 15) reported shorter prehospital delay, with effect sizes indicating important clinical differences (e.g., 1.5-2 h shorter prehospital delay). In contrast, there was limited evidence for a relationship between prehospital delay and knowledge of symptoms (n = 18), concern for troubling others (n = 18), fear (n = 17), or embarrassment in asking for help (n = 14). CONCLUSIONS The current review shows that symptom attribution to cardiac events and some degree of perceived threat are fundamental to speed up help-seeking. In contrast, social concerns and barriers in seeking medical attention (embarrassment or concern for troubling others) may not be as important as initially thought. The current review also shows that the use of very diverse methodological practices strongly limits the integration of evidence into meaningful recommendations. We conclude that there is urgent need for common guidelines for prehospital delay study design and reporting.
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Merten JW, Hamadi H, Wheeler M. Cancer risk perception predictors for total body skin examinations: a cross-sectional study using Health Information National Trends Survey (HINTS) 2017 data. Int J Dermatol 2020; 59:829-836. [PMID: 32459047 DOI: 10.1111/ijd.14935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the lack of national skin cancer screening recommendations, a total body skin examination by a healthcare provider may detect skin cancer earlier, allowing for more effective treatment and better outcomes. OBJECTIVE Examine prevalence, demographic, and cancer risk perceptions of adults who have had a skin examination performed by a healthcare provider. METHODS Retrospective, cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having a skin examination, risk perceptions, and demographic variables. RESULTS Approximately 46% of the sample reported having a skin examination. Females, college graduates, those with a history of skin cancer, people who check their skin for signs of skin cancer, and adults over the age of 45 were more likely to have a skin examination. The people least likely to be screened were those not wanting to know their chances of getting cancer. LIMITATIONS HINTS is a cross-sectional survey which provides only a glimpse of predictors. CONCLUSIONS The findings are consistent with other studies that people sometimes avoid cancer risk information. An educational intervention focused on the benefits of early cancer detection would benefit people who report not wanting to know their chances of getting cancer.
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Affiliation(s)
- Julie W Merten
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Hanadi Hamadi
- Department of Health Administration, University of North Florida, Jacksonville, FL, USA
| | - Meghann Wheeler
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
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Lubuzo B, Ginindza T, Hlongwana K. The barriers to initiating lung cancer care in low-and middle-income countries. Pan Afr Med J 2020; 35:38. [PMID: 32499854 PMCID: PMC7245978 DOI: 10.11604/pamj.2020.35.38.17333] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 11/09/2019] [Indexed: 12/18/2022] Open
Abstract
Lung cancer in low-and middle-income countries is the leading and the second leading cause of cancer deaths in males and females, respectively. This, in part, is due to late presentation of patients in health facilities and late diagnosis, thereby compromising the effectiveness of treatment and resulting in poor treatment outcomes. Investigating patients’ late presentation to health facilities and late diagnosis, as barriers to achieving good treatment outcomes, is an important step towards improving the existing pathways of care. Therefore, the aim of this paper is to critically review the published and unpublished literature, including government reports on lung cancer care, with regards to the barriers to patient access, referral, diagnosis and treatment in low-and middle-income countries. The emphasis is on access point and the primary care continuum. This review has been packaged into themes in order to efficiently inform researchers and cancer health professionals, on the existing gaps necessary for developing appropriate intervention strategies and policy guidelines. This review has revealed that the timeous and correct diagnosis of lung cancer enables lung specialists to engage on options for improved patient care. Currently, there are variations in lung cancer management in low-and middle-income countries. Many of the factors impacting on health care outcomes are a function of patient circumstances and/or understanding, leading to delays in presentation to health facilities. Factors pertaining to individual patient circumstances are further compounded by inefficiencies within the health care system. Therefore, limited health system capacities and competing health priorities in these settings require action.
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Affiliation(s)
- Buhle Lubuzo
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Themba Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Khumbulani Hlongwana
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4041, South Africa
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Momeni M, Rafii F. Help-seeking behaviour for cancer symptoms: an evolutionary concept analysis. Scand J Caring Sci 2019; 34:807-817. [PMID: 31749236 DOI: 10.1111/scs.12788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/09/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cancer survival largely depends on its early diagnosis. Therefore, assessing help-seeking behaviours among people with potential symptoms of cancer is essential. AIM This study aimed to analyse the concept of help-seeking behaviour for cancer symptoms. METHODS This concept analysis was conducted using Rodger's evolutionary method. An online literature search was conducted in the PubMed, Scopus and Cochrane databases to find relevant articles published from 2000 to 2017 in English peer-reviewed journals. In total, ninety articles were included in the study. Through thematic analysis, the data were analysed for the definitions, attributes, antecedents and consequences of the concept of help-seeking behaviour for cancer symptoms. RESULTS The concept of help-seeking behaviour for cancer symptoms includes a chain of behaviours and is defined as the process of informed decision-making for seeking medical help and using healthcare services after the detection of the first potential cancer symptoms. The attributes of the concept of help-seeking behaviour for cancer symptoms include process, problem-centeredness, intentional action and interpersonal interaction. Antecedents of the concept of help-seeking behaviour for cancer symptoms were broadly categorised as its facilitators and barriers, among which old age, young age, marriage, low education level, positive family history of cancer, fear over cancer, low perceived threat, symptom disclosure to significant others are both facilitator and barrier. The consequences of the concept of help-seeking behaviour for cancer symptoms were also broadly categorised in the two main categories of positive consequences and adverse consequences. CONCLUSIONS Help-seeking behaviour is a multidimensional time-dependent and context-bound concept which is usually defined based on the concept of time in order to facilitate its measurement. It is generally used for assessing patients' delay in seeking medical help. The findings of this study provide better understanding about the concept of help-seeking behaviour for cancer symptoms and its implications for research and practice.
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Affiliation(s)
- Maryam Momeni
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Forough Rafii
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Grimm LJ, Shelby RA, Knippa EE, Langman EL, Miller LS, Whiteside BA, Soo MS. Frequency of Breast Cancer Thoughts and Lifetime Risk Estimates: A Multi-Institutional Survey of Women Undergoing Screening Mammography. J Am Coll Radiol 2019; 16:1393-1400. [DOI: 10.1016/j.jacr.2018.12.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/11/2018] [Accepted: 12/19/2018] [Indexed: 11/30/2022]
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Wintergerst MWM, Bouws J, Loss J, Heimes B, Pauleikhoff D, Holz FG, Finger RP. [Reasons for delayed and discontinued therapy in age-related macular degeneration]. Ophthalmologe 2019; 115:1035-1041. [PMID: 29138977 DOI: 10.1007/s00347-017-0610-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Critical prerequisites for successful therapy of neovascular age-related macular degeneration (nvAMD) are an early initiation and continuous monitoring; however, delays in starting therapy and non-medically indicated discontinuation of therapy are frequent, which limits therapy efficacy and, thus, visual outcomes. OBJECTIVE To identify the reasons for delay in therapy and non-medically indicated termination of therapy. MATERIAL AND METHODS Patients who had started a new therapy (starters) and those who independently terminated therapy (dropouts) were interviewed by telephone with a specific, standardized questionnaire. Results were summarized descriptively. RESULTS A total of 100 starters and 55 dropouts were interviewed. The mean therapy delay was 22 (±28 SD) days. This was mainly due to the time until the decision to see an ophthalmologist was made. Main reasons for dropping out were: transportation issues (27%), poor general health (25%) and the assumption that there is no benefit from therapy (11%). Of the patients who dropped out 63% would have liked to continue therapy. CONCLUSION There is potential for improvement in nvAMD management regarding therapy start as well as therapy maintenance. Sensitizing for initial nvAMD symptoms is important as is reduction of barriers to therapy maintenance, since most therapy dropouts would like to continue the therapy.
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Affiliation(s)
| | - J Bouws
- AMD-Netz, Münster, Deutschland
| | - J Loss
- Medizinische Soziologie, Institut für Epidemiologie und präventive Medizin, Universität Regensburg, Regensburg, Deutschland
| | - B Heimes
- St. Franziskus-Hospital Münster, Münster, Deutschland
| | - D Pauleikhoff
- St. Franziskus-Hospital Münster, Münster, Deutschland
| | - F G Holz
- Universitäts-Augenklinik Bonn, Bonn, Deutschland
| | - R P Finger
- Universitäts-Augenklinik Bonn, Bonn, Deutschland.
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Mazzocco K, Masiero M, Carriero MC, Pravettoni G. The role of emotions in cancer patients' decision-making. Ecancermedicalscience 2019; 13:914. [PMID: 31123497 PMCID: PMC6467455 DOI: 10.3332/ecancer.2019.914] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Despite the attempt to make decisions based on evidence, doctors still have to consider patients' choices which often involve other factors. In particular, emotions seem to influence the way that options and the surrounding information are interpreted and used. OBJECTIVE The objective of the present review is to provide a brief overview of research on decision making and cancer with a specific focus on the role of emotions. METHOD Thirty-nine studies were identified and analysed. Most of the studies investigated anxiety and fear. Worry was the other psychological factor that, together with anxiety, played a crucial role in cancer-related decision-making. RESULTS The roles of fear, anxiety and worry were described for detection behaviour, diagnosis, choice about prevention and curative treatments and help-seeking behaviour. Results were inconsistent among the studies. Results stressed that cognitive appraisal and emotional arousal (emotion's intensity level) interact in shaping the decision. Moderate levels of anxiety and worry improved decision-making, while low and high levels tended to have no effect or a hindering effect on decision making. Moderating factors played an under-investigated role. CONCLUSIONS Decision making is a complex non-linear process that is affected by several factors, such as, for example, personal knowledge, past experiences, individual differences and certainly emotions. Research studies should investigate further potential moderators of the effect of emotions on cancer-related choice. Big data and machine learning could be a good opportunity to test the interaction between a large amount of factors that is not feasible in traditional research. New technologies such as eHealth and virtual reality can offer support for the regulation of emotions and decision making.
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Affiliation(s)
- Ketti Mazzocco
- Department of Oncology and Hemato-oncology, University of Milan, 20122 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Marianna Masiero
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20122 Milan, Italy
| | - Maria Chiara Carriero
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-oncology, University of Milan, 20122 Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, 20141 Milan, Italy
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Ladwig KH. Anxiety weights down the heart - New evidence for a toxic cardiovascular risk factor. Int J Cardiol 2019; 278:261-262. [PMID: 30578092 DOI: 10.1016/j.ijcard.2018.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/30/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Karl-Heinz Ladwig
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, München, Germany; Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partnersite Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
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Macdonald S, Conway E, Bikker A, Browne S, Robb K, Campbell C, Steele RJ, Weller D, Macleod U. Making sense of bodily sensations: Do shared cancer narratives influence symptom appraisal? Soc Sci Med 2019; 223:31-39. [PMID: 30703697 DOI: 10.1016/j.socscimed.2018.12.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 12/04/2018] [Accepted: 12/23/2018] [Indexed: 01/22/2023]
Abstract
Though new or altered bodily sensations are a common occurrence they rarely transition to biomedically defined symptoms. When they do, sensations are subject to an appraisal process that can culminate in help-seeking. The transition has particular relevance for cancer diagnoses. Studies of 'symptom appraisal' in cancer patients typically conclude that failure to regard sensations as serious or 'symptom misattribution' results in lengthier help-seeking intervals. Though multiple influences on appraisal processes are acknowledged, including the socio-cultural context, detailed description and analyses of how socio-cultural factors shape appraisal is lacking. In this paper we explore one substantial component of the sociocultural context, namely, publicly recognised shared cancer narratives, and their impact on appraisal. We undertook a secondary analysis of 24 interviews with Scottish colorectal cancer patients originally completed in 2006-2007. Our analysis showed that fear, death and severity dominated cancer narratives and were frequently restated throughout interviews. Yet, early bodily changes were often mild and vague, were commonly experienced in the context of 'feeling well' and failed to match preconceived ideas of what cancer 'feels like'. Moreover, few perceived themselves to be 'at risk' of cancer and diagnoses were characterised as 'shocking' events. Participants engaged in self-monitoring strategies and severe or painful changes prompted help-seeking. Far from misattributing symptoms, responses to bodily changes were sensible and measured; responses are particularly apt in relation to current policy rhetoric, which urges measured use of services. Our findings have resonance across healthcare settings as patients are required to negotiate a narrow and challenging space when making decisions to seek help. There is a pressing need for a more realistic approach to symptom appraisal in order to reduce help-seeking intervals. Future awareness campaigns should emphasise the importance of vague/minor bodily changes although this will necessitate discussions with health professionals on referral thresholds to achieve earlier detection.
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Affiliation(s)
- Sara Macdonald
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 8QQ, UK.
| | - Elaine Conway
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Annemieke Bikker
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Susan Browne
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Kathryn Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Christine Campbell
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Robert Jc Steele
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - David Weller
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Una Macleod
- Hull York Medical School, University of Hull, Hull, HU6 7RX, UK
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Azhar N, Doss JG. Health-Seeking Behaviour and Delayed Presentation of Oral Cancer Patients in a Developing Country: A Qualitative Study based on the Self-Regulatory Model. Asian Pac J Cancer Prev 2018; 19:2935-2941. [PMID: 30362327 PMCID: PMC6291039 DOI: 10.22034/apjcp.2018.19.10.2935] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022] Open
Abstract
Background: The aim of this study was to explore reasons for delayed health-seeking for late stage oral cancer patients. Methods: Semi-structured in-depth interviews were conducted with 35 oral cancer patients with TNM stage III to IV disease, who were treated at six tertiary regional centres managing oral cancer throughout Malaysia. Interviews were audio-recorded, transcribed verbatim, coded using NVivo (version 10.0) qualitative software and analysed using framework analysis. Results: Participants interpreted their early symptoms as a minor condition and did not consider it as requiring immediate attention. Four types of coping strategies causing delayed help-seeking emerged: 1) self-remedy 2) self-medication 3) seeking traditional healers and 4) consulting general medical practitioners (GPs) instead of dentists. Socio-economic factors, cultural beliefs and religious practices have some influence on diagnostic delay. Conclusion: Low levels of public knowledge and awareness regarding early signs and symptoms of oral cancer as well as GPs’ misdiagnosis of early lesions results in delayed diagnosis.
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Affiliation(s)
- Nurizyani Azhar
- Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
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Mourad G, Jaarsma T, Strömberg A, Svensson E, Johansson P. The associations between psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter? BMC Psychiatry 2018; 18:172. [PMID: 29866125 PMCID: PMC5987660 DOI: 10.1186/s12888-018-1689-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 04/16/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Psychological distress such as somatization, fear of body sensations, cardiac anxiety and depressive symptoms is common among patients with non-cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, cardiac anxiety, and depressive symptoms) and healthcare use in patients with non-cardiac chest pain in relation to history of cardiac disease. METHODS In total, 552 patients with non-cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of cardiac disease. RESULTS A total of 34% of the patients had previous cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and cardiac anxiety, and this effect was significantly stronger in patients with history of cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, cardiac anxiety, and healthcare use were significantly stronger in patients with history of cardiac disease. CONCLUSIONS In patients with non-cardiac chest pain, in particular those with history of cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of cardiac disease or not.
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Affiliation(s)
- Ghassan Mourad
- Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, S-601 74, Norrköping, Sweden.
| | - Tiny Jaarsma
- 0000 0001 2162 9922grid.5640.7Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, S-601 74 Norrköping, Sweden
| | - Anna Strömberg
- 0000 0001 2162 9922grid.5640.7Department of Medical and Health Sciences, Linköping University, Linköping, Sweden ,0000 0001 2162 9922grid.5640.7Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Erland Svensson
- 0000 0001 0942 6030grid.417839.0Formerly Swedish Defence Research Agency, Stockholm, Sweden
| | - Peter Johansson
- 0000 0001 2162 9922grid.5640.7Department of Social and Welfare Studies, Linköping University, Kungsgatan 40, S-601 74 Norrköping, Sweden ,0000 0001 2162 9922grid.5640.7Department of Internal Medicine and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden
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Dobson C, Russell A, Brown S, Rubin G. The role of social context in symptom appraisal and help-seeking among people with lung or colorectal symptoms: A qualitative interview study. Eur J Cancer Care (Engl) 2018; 27:e12815. [PMID: 29419943 DOI: 10.1111/ecc.12815] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 12/01/2022]
Abstract
Prolonged diagnostic intervals are associated with poorer outcomes, and the patient interval appears to be a substantial contributor to the overall length of the diagnostic interval. This study sought to understand how the broader context of people's lives influenced symptom appraisal and help-seeking, comparing experiences by length of the patient interval. Patients referred with a suspicion of lung or colorectal cancer were invited to complete a questionnaire about their symptoms, with 26 respondents purposively sampled to take part in a semi-structured interview about their patient intervals. Embodied experience, appraisal, help-seeking decision-making and consultation were identified as component stages of the patient interval, with the factors affecting movement between these stages located in one of four contextual domains: individual experience, interpersonal relationships, healthcare system interactions and social and temporal context. The length of the patient interval was related to the type of symptom(s) experienced, discussion of symptoms with others and the social responsibilities people held during symptomatic periods. A contextual model of the patient interval illustrates the stages and domains of this interval, as grounded in the data from this study. The model has potential application to future studies examining the patient interval for a range of symptoms.
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Affiliation(s)
- C Dobson
- Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - A Russell
- Department of Anthropology, Durham University, Durham, Uk
| | - S Brown
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - G Rubin
- Institute of Health and Society, Sir James Spence Institute, Newcastle University, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
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Fang XY, Spieler D, Albarqouni L, Ronel J, Ladwig KH. Impact of generalized anxiety disorder (GAD) on prehospital delay of acute myocardial infarction patients. Findings from the multicenter MEDEA study. Clin Res Cardiol 2018; 107:471-478. [DOI: 10.1007/s00392-018-1208-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/26/2018] [Indexed: 12/16/2022]
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Murphy PJ, Marlow LAV, Waller J, Vrinten C. What is it about a cancer diagnosis that would worry people? A population-based survey of adults in England. BMC Cancer 2018; 18:86. [PMID: 29361912 PMCID: PMC5781324 DOI: 10.1186/s12885-017-3963-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 12/07/2017] [Indexed: 02/08/2023] Open
Abstract
Background Surveys indicate quite high prevalence of cancer worry in the general population, but little is known about what it is about cancer that worries people. A better understanding of the origins of cancer worry may help elucidate previously found inconsistencies in its behavioural effect on cancer prevention, screening uptake, and help-seeking for symptoms. In this study, we explore the prevalence and population distribution of general cancer worry and worries about specific aspects of cancer previously identified. Methods A population-based survey of 2048 English adults (18–70 years, April–May 2016), using face-to-face interviews to assess demographic characteristics, general cancer worry and twelve sources of cancer worry (adapted from an existing scale), including the emotional, physical, and social consequences of a diagnosis. Results In general, a third of respondents (37%) never worried about cancer, 57% worried occasionally/sometimes, and 6% often/very often. In terms of specific worries, two thirds would be ‘quite a bit’ or ‘extremely’ worried about the threat to life and emotional upset a diagnosis would cause. Half would worry about surgery, radiotherapy, chemotherapy, and loss of control over life. Worries about the social consequences were less commonly anticipated: just under half would worry about financial problems or their social roles, and a quarter would be worried about effects on identity, important relationships, gender role, and sexuality. Women and younger people reported more frequent worry about getting cancer, and would be more worried about the emotional, physical, and social consequences of a cancer diagnosis (p < .001). Those from ethnic minority backgrounds reported less frequent worry about getting cancer than their white counterparts, but would be equally worried about the emotional and physical impact of a cancer diagnosis, and worried more about the social consequences of a cancer diagnosis (p < .05). Conclusions The majority of English adults worry at least occasionally about getting cancer, and would be most worried about the emotional and physical impact of a cancer diagnosis. Distinguishing between the various worries that cancer can evoke may help inform efforts to allay undue worries in those who are deterred by them from engaging with cancer prevention and early detection. Electronic supplementary material The online version of this article (10.1186/s12885-017-3963-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Philippa J Murphy
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Laura A V Marlow
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Jo Waller
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK
| | - Charlotte Vrinten
- Department of Behavioural Science and Health, UCL, Gower Street, London, WC1E 6BT, UK.
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