Fear of cancer is associated with cancer information seeking, scanning and avoiding: a cross-sectional study among cancer diagnosed and non-diagnosed individuals

The care pathway experienced by cutaneous melanoma survivors: A qualitative longitudinal study

BACKGROUND

The optimal management of cutaneous melanoma is based on implementing a multidisciplinary tumour board. No studies report cutaneous melanoma patients' perspective along the whole care pathway, taking us through their care experience longitudinally.

AIMS

To explore the patients' perspective on the cutaneous melanoma care journey in a skin cancers' tertiary referral centre.

METHODS

A longitudinal qualitative study was designed, using semi-structured interviews. Cutaneous melanoma patients were interviewed three times (T0, after diagnosis; T1, after the first postoperative visit; and T2, at the follow-up). Data were analysed using the inductive framework method.

RESULTS

Fifteen patients agreed to participate, and 8 completed all three interviews. We generated three themes describing how patients experienced the care pathway: (i) the evolving need for support during the care pathway, (ii) the development of emotions and expectations for the journey's end, (iii) the changing perceptions of hospital services, the care pathway itself, and the Skin Cancer Unit. We have emphasised the shifts in the experience of receiving assistance from the diagnosis to the follow-up stage. The more the care process progressed, the stronger the need for a relationship with healthcare professionals. The emotional impact of becoming a cancer survivor exacerbated the experience and reflected on patients' perceptions of the care pathway.

CONCLUSIONS

Adopting a relational approach to reassuring melanoma patients is essential. Our participants expressed needing a medical reference figure as a favourable element. When this is unfeasible, inter-professional training is desirable to help professionals cooperate in a multidisciplinary group and make this collaboration visible to patients.

Fear in general populations: A cross-sectional study on perceived fear of common diseases, COVID-19, life events, and environmental threats in 30 countries

Background

In this study, we assessed the general population's fears towards various diseases and events, aiming to inform public health strategies that balance health-seeking behaviours.

Methods

We surveyed adults from 30 countries across all World Health Organization (WHO) regions between July 2020 and August 2021. Participants rated their fear of 11 factors on an 11-point Likert scale. We stratified the data by age and gender and examined variations across countries and regions through multidimensional preference analysis.

Results

Of the 16 512 adult participants, 62.7% (n = 10 351) were women. The most feared factor was the loss of family members, reported by 4232 participants (25.9%), followed by cancer (n = 2248, 13.7%) and stroke (n = 1416, 8.7%). The highest weighted fear scores were for loss of family members (mean (x̄) = 7.46, standard deviation (SD) = 3.04), cancer (x̄ = 7.00, SD = 3.09), and stroke (x̄ = 6.61, SD = 3.24). The least feared factors included animals/insects (x̄ = 3.72, SD = 2.96), loss of a mobile phone (x̄ = 4.27, SD = 2.98), and social isolation (x̄ = 4.83, SD = 3.13). Coronavirus disease 2019 (COVID-19) was the sixth most feared factor (x̄ = 6.23, SD = 2.92). Multidimensional preference analyses showed distinct fears of COVID-19 and job loss in Australia and Burundi. The other countries primarily feared loss of family members, cancer, stroke, and heart attacks; this ranking was consistent across WHO regions, economic levels, and COVID-19 severity levels.

Conclusions

Fear of family loss can improve public health messaging, highlighting the need for bereavement support and the prevention of early death-causing diseases. Addressing cancer fears is crucial to encouraging the use of preventive services. Fear of non-communicable diseases remains high during health emergencies. Top fears require more resources and countries with similar concerns should collaborate internationally for effective fear management.

Linking patient-centered communication with cancer information avoidance: The mediating roles of patient trust and literacy

OBJECTIVES

This study, drawing on the pathway mediation model developed by Street and his colleagues (2009) that links communication to health outcomes, explores how patient-centered communication affects cancer information avoidance.

METHODS

Data was gathered through online access panel surveys, utilizing stratified sampling across Germany, Switzerland, the Netherlands, and Austria. The final sample included 4910 non-cancer and 414 cancer patients, all receiving healthcare from clinicians within the past year.

RESULTS

The results demonstrated that patient-centered communication is directly associated with reduced cancer information avoidance, especially among cancer patients. Additionally, this association is indirectly mediated through patient trust and healthcare literacy.

CONCLUSION

The findings provide empirical evidence that reveals the underlying mechanism linking clinician-patient communication to patient health information behavior.

PRACTICE IMPLICATIONS

The potential of clinician-patient communication in addressing health information avoidance is highlighted by these findings. Future interventions in healthcare settings should consider adopting patient-centered communication strategies. Additionally, improving patient trust and literacy levels could be effective in reducing cancer information avoidance.

"I Saw it Incidentally but Frequently": Exploring the Effects of Online Health Information Scanning on Lung Cancer Screening Behaviors Among Chinese Smokers

In China, lung cancer is the most common cancer with high mortality. While prior research suggests that health information scanning influences cancer screening within the general population, a deeper exploration of the underlying mechanisms is imperative. This study specifically targets smokers, aiming to investigate whether online health information scanning can effectively encourage lung cancer screening and elucidate the mechanisms driving this association. Data were extracted from a Chinese national survey conducted between January and September 2023, exclusively involving current smokers (N = 992). A moderated mediation model was employed to examine a cognitive-affective sequential chain of mediation through risk perceptions and cancer worry. Results showed that 99.1% of Chinese smokers reported online health information scanning, which possessed significant influence. Online health information scanning was positively associated with effective lung cancer screening among smokers directly (OR = 1.927, p < .01) and indirectly (OR = .065, p < .001). The perceived threat of smoking and cancer worry served as the cognitive and affective mediating mechanisms. Furthermore, a moderating effect of eHealth literacy was observed (OR = 6.292, p < .05). Smokers with higher eHealth literacy are more inclined to undergo effective lung cancer screening. Based on these findings, public health sectors should leverage online platforms to disseminate tailored cancer screening education and implement initiatives to enhance public eHealth literacy.

Examining Antecedents of Factual Knowledge and Perceived Familiarity of COVID-19 Contact Tracing App: A Modified Cognitive Mediation Model

This study employs a modified cognitive mediation model to investigate the role of health valuation and fear in shaping media attention, factual knowledge, and perceived familiarity with COVID-19 contact tracing apps. Data were collected from a national survey of 906 Singaporeans, and structural equation modeling was used to analyze the results. Findings indicated that both fear of COVID-19 and health valuation were positively associated with newspapers, television, and social media attention, with health valuation demonstrating a stronger association with each media type. This suggests that health valuation, as an intrinsic motivation, is more critical in information-seeking behavior related to emerging health technologies. However, media attention on all platforms did not correlate with factual knowledge of COVID-19 contact tracing apps, whereas attention to social media was positively associated with perceived familiarity with these apps. This result highlights the potential influence of social media in shaping public perceptions, warranting further investigation into the quality and accuracy of the information disseminated. News elaboration was found to have a positive association with both factual knowledge and perceived familiarity with COVID-19 contact tracing apps. This underscores the need for effective communication strategies to promote accurate understanding of health technologies and emphasizes the role of individual motivations in shaping media consumption and information processing.

Research on the Process and Influencing Factors of Online Diabetes Information Users’ Avoidance Behavior: A Qualitative Study

Users’ avoidance behavior of health information has received growing attention recently, but research into users’ avoidance behavior of diabetes information remains limited. This paper aims to reveal the process and the factors of avoiding online diabetes information. The interview, conducted with the critical incident technique, and the diary methods were used to collect 40 true incidents of online diabetes information avoidance from 17 participants. Based on the thematic analysis method and grounded theory, the data were analyzed to identify the key phases of the avoidance process and obtain the factors influencing the occurrence of avoidance behavior. The results showed that the macro-process of online diabetes information avoidance comprised three phases: pre-encountering, encountering, and avoiding after encountering. First, browsing, searching, or social interaction provide the context for encountering; second, the encountering occurrence consists of three steps—noticing the stimuli, reacting to stimuli, and examining the content; and third, to avoid the online diabetes information encountered, users will adopt avoidance strategies, such as avoiding information sources, controlling attention, delaying access, forgetting information, and denying information, which is manifested as general avoidance and strong avoidance, and has positive, negative, or no effect on users. The 14 influencing factors of avoidance behavior obtained were divided into four clusters. User-related factors include demographic characteristics, health-behavior perception, perceived threat, perceived control, and information sufficiency; information-related factors include information quality, information overload, and information dissemination; environment-related factors include context type, behavior place, time pressure, and social factors, and emotion-related factors include the pre-encountering and post-encountering emotional states. These findings can guide the intervention of information avoidance behavior.

Assessing the interrelationship between stigma, social influence, and cervical cancer prevention in an urban underserved setting: An exploratory study

In the US, incidence and mortality from cervical cancer disproportionately affects racial/ethnic minorities and low-income women. Despite affordable access to primary and secondary prevention measures at Federally Qualified Health Centers (FQHCs), Human Papillomavirus (HPV) vaccination and screening rates are low, suggesting the presence of non-financial barriers to uptake in this population. This explanatory sequential mixed-methods study sought to explore factors that influence the acceptability of cervical cancer prevention services among parents and legal guardians of vaccine-eligible girls attending an urban FQHC and to assess social influences related to cervical cancer prevention. Participants included eight mothers, one father, and two grandparents/legal guardians. Nine participants self-identified as Black/Afro-Caribbean, or African American, two as Latinx, and one as Native American. The quantitative data suggested discordance between participants' cervical cancer prevention knowledge and their practices. Most indicated that their daughters had received the HPV vaccine but were unsure about HPV transmission modes. Qualitative data revealed that participants were comfortable disclosing information on HPV infection and vaccination status, and most women were likely to share information related to cervical cancer testing and diagnosis. Few comments indicated personal stigma on the part of participants, but there was frequent expression of perceived public stigma (shaming and blaming women), gender differences (men are indifferent to risk), and distrust of the healthcare system. Findings highlight several concepts including the disharmony between knowledge and practice, prevalent perceived public stigma, cumbersome attitudes on the part of men regarding HPV and cervical cancer, and distrust of the healthcare system.

Waiting for medical test results: A delay discounting approach

RATIONALE AND OBJECTIVE

Delay discounting is the devaluation of an outcome as a function of delay until receiving that outcome. In two studies, we used a delay discounting approach to examine how wait times for a medical diagnosis can affect people's decision to undergo medical testing.

METHODS

In Study 1 (N = 151), participants rated the likelihood they would get tested for a severe and a mild disease with wait times ranging from 0 to 180 days (within persons). Study 2 (N = 400) randomized disease severity (severe vs. mild) between persons and manipulated disease curability (curable vs. incurable).

RESULTS

Likelihood of testing decreased as delay until receiving test results increased. This effect of delay on testing was stronger for the mild than for the severe disease, and for the curable than for the incurable disease.

CONCLUSIONS

We found strong evidence for a delay discounting effect, an effect that varied depending on aspects of diseases. The findings illustrate how delay discounting can affect screening uptake and how it is moderated by disease characteristics.

Explaining cancer information avoidance comparing people with and without cancer experience in the family

OBJECTIVES

Cancer information avoidance (CIA) serves as a barrier to preventive efforts. To learn how to combat this barrier, we aim to examine predictors of CIA in populations with and without cancer experience in the family, which are addressed differently in cancer prevention, according to specific informational barriers.

METHODS

A subsample of people with and without cancer in the family (n = 2,757) of an online survey with a sample stratified for the German population by age, gender, education, and region was conducted via an online access panel. The survey instrument was adapted from the Health Information National Trends Survey. Separate stepwise regression analyses were conducted.

RESULTS

Only a comparatively small proportion of the variance in CIA was explained by the predictors, ranging from R²  = .148 for people without cancer experience to R²  = .180 for participants with cancer experience in their family. Across the groups, the findings showed that people who were fatalistic about the risk of cancer, less health literate, who perceived less social pressure to be informed, and were less trusting in information sources more often avoided cancer information.

CONCLUSIONS

Our findings identify relevant target groups to be addressed and barriers to be removed for cancer communication efforts. Adequate information provision can be supported by programs for fostering health literacy and social network diffusion strategies.

Predictors of Health Information-Seeking Behavior: Systematic Literature Review and Network Analysis

Background

People engage in health information–seeking behavior to support health outcomes, and being able to predict such behavior can inform the development of interventions to guide effective health information seeking. Obtaining a comprehensive list of the predictors of health information–seeking behavior through a systematic search of the literature and exploring the interrelationship of these predictors are critical first steps in this process.

Objective

This study aims to identify significant predictors of health information–seeking behavior in the primary literature, develop a common taxonomy for these predictors, and identify the evolution of the concerned research field.

Methods

A systematic search of PsycINFO, Scopus, and PubMed was conducted for all years up to and including December 10, 2019. Quantitative studies identifying significant predictors of health information–seeking behavior were included. Information seeking was broadly defined and not restricted to any source of health information. Data extraction of significant predictors was performed by 2 authors, and network analysis was conducted to observe the relationships between predictors with time.

Results

A total of 9549 articles were retrieved, and after the screening, 344 studies were retained for analysis. A total of 1595 significant predictors were identified. These predictors were categorized into 67 predictor categories, with the most central predictors being age, education, gender, health condition, and financial income. With time, the interrelationship of predictors in the network became denser, with the growth of new predictor grouping reaching saturation (1 new predictor identified) in the past 7 years, despite increasing publication rates.

Conclusions

A common taxonomy was developed to classify 67 significant predictors of health information–seeking behavior. A time-aggregated network method was developed to track the evolution of the research field, showing the maturation of new predictor terms and an increase in primary studies reporting multiple significant predictors of health information–seeking behavior. The literature has evolved with a decreased characterization of novel predictors of health information–seeking behavior. In contrast, we identified a parallel increase in the complexity of predicting health information–seeking behavior, with an increase in the literature describing multiple significant predictors.

Finding useful cancer information may reduce cancer information overload for Internet users

BACKGROUND

An excessive overload of information causes an ineffective management of information, stress and indefiniteness. Furthermore, this situation can prevent persons from learning and making conscious decisions.

OBJECTIVE

This study aims to determine the cancer information overload (CIO) and the factors related to it in adults who are Internet users.

METHODS

A cross-sectional study with 482 Internet users was conducted. The data were collected by using an Introductory Information Form and the Cancer Information Overload Scale.

RESULTS

It was found that the Internet was the most used information source (62.2%). The CIO of those with a university level education was found to be high (P = 0.012). It was found that the CIO of individuals who used the Internet (P = 0.031) and newspapers/magazines (P = 0.004) as sources of information was high compared with those who did not use these sources. It was determined from the information obtained that those who found the information to be beneficial and enough had a low CIO (P = 0.004, P = 0.00).

CONCLUSION

Health literacy around cancer information is challenging for frequent Internet users. Health professionals, information specialists and librarians should orient people to reliable sources.

Information Seeking Behavior About Cancer and Associated Factors Among University Students, Ethiopia: A Cross-Sectional Study

Introduction

Cancer is among the leading cause of death in sub-Saharan Africa over the last few years, putting a tremendous physical, emotional, and financial strain on individuals, families, and health systems. Many health systems in sub-Saharan Africa are least prepared to manage this burden, and a large number of individuals do not have access to quality cancer-related information to prevent and manage cancer. Understanding the information seeking behavior of individuals, especially university students who are more likely to seek health information than other people, can be seen as an opportunity to provide resources to improve lifestyle or prevent possible health-threatening behaviors of individuals.

Objective

This study aimed to assess cancer information seeking behavior (CISB) and its associated factors among students in Debre Tabor University, Ethiopia.

Methods

An institution-based cross-sectional study design was conducted among students at Debre Tabor University from March 01 to March 30, 2019. A total of 844 students were selected using a multistage stratified sampling technique. Data were collected using a structured and pre-tested questionnaire by trained data collectors. Data entry and analyses were performed using Epi info version 7.2 and SPSS version 20, respectively. Descriptive and inferential statistics were used to explore the socio-demographic information and cancer information seeking behavior. Binary logistic regression was used to identify factors associated with cancer information seeking.

Results

The proportion of cancer information seeking by students in the past 12 months was 30.1%. Their preferred source of information about cancer was health-care providers (48%) followed by the Internet (27.6%). Year of study, Internet access (AOR=6.07, 95% CI= 4.05, 9.10), health literacy level (AOR=1.8, 95% CI=1.21, 2.68), self-reported health condition (AOR=1.85, 95% CI=1.25, 2.73), perceived susceptibility to cancer (AOR=2.48, 95% CI=1.47, 4.2), and perceived severity of cancer (AOR=3.33, 95% CI=1.85, 6.0) were the factors associated with cancer information seeking.

Conclusion

The proportion of cancer information seeking among university students was low. Being 3rd- and 4th-year student, internet access, being healthy, adequate health literacy level, concerning about cancer, and higher perceived severity of cancer were significantly associated with cancer information seeking. Increase health literacy and awareness creation about cancer for students will help to seek cancer information.

Targeting Perceptions of Risk from Injudicious Antibiotic Use: An Application of the Risk Information Seeking and Processing Model

Enhancing knowledge about antibiotic-associated risks is key to reducing injudicious antibiotic use and slowing antibiotic resistance. Using the Risk Information Seeking and Processing (RISP) model, the study identified predictors of individuals' seeking and avoidance of information about antibiotic risks and tested the effectiveness of exposure to a RISP-informed video intervention against exposure to a CDC-produced video and a control group. In a national sample (N = 1000), risk judgment led to greater negative affect toward risks of antibiotics and lower positive affect toward antibiotic usefulness. In turn, positive and negative affect shaped information insufficiency, which interacted with perceived information gathering capacity to influence risk information seeking and avoidance. In addition, informational subjective norms and affective responses directly shaped individuals' information behavior. Results showed that relative to the control group, participants viewing the RISP-informed video had greater risk judgment, perceived current knowledge about antibiotic risks, perceived information gathering capacity, and informational subjective norms, as well as lower levels of positive affect toward antibiotics. The RISP-informed video and CDC-produced video performed equivalently well. Implications of the findings for the design of antibiotic stewardship messages are discussed.

Meanings and dimensions of cancer by sick people - a structural analysis of social representations

OBJECTIVE

To describe the contents and structure of the social representation of cancer.

METHOD

A qualitative study based on the Theory of Social Representations, carried out in a High Complexity Care Unit in Oncology. Data collection included a socio-occupational and clinical characterization questionnaire and free evocations form from 100 cancer patients in chemotherapy treatment and in-depth interviews with 29 of them. The analysis was performed using EVOC software.

RESULTS

One hundred (100) patients participated in the study. The social representation of cancer has the words normal, difficult disease, death and fear in its central nucleus. The apparent ambivalence between the continuity of life and its finitude as structuring meanings of this representation enables establishing an inferential hypothesis that relates normal disease to the possibility of treatment, control and cure of cancer, while the fear of death remains in the representational field linked to the disease, which has a difficult treatment to cope with.

CONCLUSION

The social representations of cancer based on the presented interrelationships provide reflections which may contribute to increasing the individual and social care of patients with malignant neoplasm and their family in health services.

Health Literacy Influences Men's Active and Passive Cancer Information Seeking

Background:

For cancer prevention information to be effective, it must be accessible to its target populations. Prevalence of inadequate health literacy (HL) is high, but there is a dearth of information on the impact of HL on men's cancer information seeking.

Objective:

We investigated (1) men's cancer information seeking behaviors, (2) the effect of HL on men's cancer information seeking behavior, and (3) men's preferences for cancer information, considering their HL level. From a national perspective, we investigated men's information seeking behavior from the Irish Cancer Society (ICS), the largest provider of cancer information in Ireland.

Methods:

Men from adult literacy classes and men's groups were invited to complete a questionnaire. General and ICS-specific cancer information seeking behavior was investigated. Univariate and multivariate logistic regression models were conducted with “ever” seeking cancer information from any source, and actively seeking and passively acquiring ICS information as dependent variables.

Key Results:

Overall, 259 men completed the questionnaire and 44% had inadequate HL. About one-half of responders reported “ever” actively looking for cancer information. In the study group, 19% actively sought and 67% passively acquired ICS-specific information. In multivariate analysis, the odds of actively seeking (2.93; 95% CI [1.05, 8.15]) or passively acquiring (4.7; 95% CI [1.99, 11.05]) ICS-specific cancer information was significantly higher among those with adequate versus inadequate HL, respectively. HL was not significantly associated with odds of “ever” cancer information seeking in multivariate analysis (odds ratio 1.81; 95% CI [0.90, 3.63]). Men want information about cancer prevention. Suggested future cancer information sources differed by HL levels. General practitioners and the Internet were the preferred source for men with inadequate (53.3%) and adequate HL (57%), respectively.

Conclusions:

Men both passively acquire and actively seek cancer prevention information. Multimodal dissemination of cancer prevention information is necessary to reach a wide cross-section of men, including those with inadequate HL. This could potentially lower men's cancer burden and reduce gender inequalities in cancer mortality. [HLRP: Health Literacy Research and Practice. 2019;3(3):e147–e160.]

Plain Language Summary:

Most men get cancer prevention information by coming across it passively in their daily lives, instead of actively looking for this information. Men with low health literacy are less likely to obtain cancer information both passively and actively. Men want this information. Organizations need to make this information available in many places and formats (e.g., Internet, doctor, television, sports clubs).

Moving from fear to realization: Family engagement in tuberculosis prevention in children living in tuberculosis Sundanese households in Indonesia

OBJECTIVE

Children living in tuberculosis households need protection. However, families need to be engaged to prevent tuberculosis transmission to children. This study aimed to analyze the details of "moving from fear to realization," which is one category of a substantive theory of family engagement in tuberculosis prevention in children.

METHODS

Fourteen family caregivers participated as key informants after their families met the criteria. The participants were recruited at a lung clinic in West Java, Indonesia and followed up at their homes. The data were gathered using in-depth interviews and analyzed following the coding procedures of the Straussian grounded theory.

FINDINGS

"Moving from fear to realization" was the main category that emerged from the experiences of the Sundanese families to begin engaging in tuberculosis prevention in children living in tuberculosis households. It was composed of four sub-categories, namely, fear of tuberculosis, seeking information, following God's will, and awareness of tuberculosis transmission risks.

CONCLUSIONS

This study showed how a family moves from fear to the realization of tuberculosis transmission risks. Its findings are useful for nurses to provide optimum care in order to prevent tuberculosis transmission to children with household contact by providing both education and counseling for families.

A scoping review of consumer needs for cancer information

OBJECTIVE

This study was a scoping review of research on cancer-related health information seeking and needs of patients, survivor, non-patients, and caregivers.

METHODS

This study used the COSI model to search for articles published from 2007 to 2017.

RESULTS

In total, 117 articles with titles and abstracts including the following terms were selected: cancer, health, information, seeking. Non-patients obtained information from the Internet, doctors, and media, whereas patients obtained information from doctors, the Internet, and media. Information needs were the highest for treatment, prognosis, and psychosocial support. Patients had the highest need for information on prognosis and treatment, whereas non-patients had the highest need for general cancer information, prevention, and cancer examination. Caregivers sought information about treatment, psychosocial support, and prevention.

CONCLUSION

This study revealed an increase in the number of research articles identifying cancer patients' information needs. Cancer patients rely on health professionals for information; thus, relevant materials are needed. Furthermore, not only medical but also psychosocial support information is needed.

PRACTICE IMPLICATIONS

There is a need for cancer information from health professionals, and thus for patient-centered training materials. Furthermore, a survey system to evaluate consumers' cancer information needs should be developed.

Spanish-Speaking Hispanic Patients' Information-Sharing Preferences During Hospitalization: An Exploratory Pilot Study

BACKGROUND

Self-management of chronic conditions, such as cancer or diabetes, requires the coordination of care across multiple care settings. Current patient-centered, hospital-based care initiatives, including bedside nursing handoff and multidisciplinary rounds, often focus on provider information exchange and roles but fall short of the goals of participatory medicine, which recognize the right of patients to partner in their own care and play an active role in self-management.

OBJECTIVE

This study aimed to elicit Spanish-speaking Hispanic patients' perspectives on the exchange and sharing of information during hospitalization.

METHODS

This exploratory pilot study incorporated a qualitative descriptive approach by using Spanish language focus groups, posthospitalization, to determine patient-identified information needs during hospitalization.

RESULTS

Participants preferred paper-based Spanish language medical information. Doctors and nurses were key information providers and communicated with participants verbally, usually with the assistance of a translator. Participants expressed a desire to be informed about medication and treatments, including side effects and why there were changes in medication during hospitalization. In addition, they expressed interest in knowing about the progress of their condition and when they could expect to go home. Emotional readiness to receive information about their condition and prognosis was identified as an individual barrier to asking questions and seeking additional information about their condition(s).

CONCLUSIONS

Overall, participants shared positive experiences with providers during hospitalization and the usefulness of self-care instructions. Language was not recognized as a barrier by any of the participants. Nevertheless, future research on the influence of emotional readiness on the timing of medical information is needed.

["Dr. Google"-information-seeking behavior and disease-specific anxiety among men with localized prostate cancer]

BACKGROUND AND OBJECTIVE

After the diagnosis of localized prostate cancer (LPCa), many men seek additional information about their disease. However, it is not yet proven how different sources of information influence uncertainty and disease-specific anxiety. The aim of this study is to investigate to what extent different types of information sources, the number of used sources and the perceived level of information are predictive of disease-specific anxiety.

MATERIALS AND METHODS

Men with LPCa (N = 292; n = 150 radical prostatectomy, n = 142 active surveillance) completed questionnaires assessing sociodemographic variables, number and type of sources of information used, perceived level of information, and disease-specific anxiety. The association of information-seeking behavior with anxiety was tested using moderated sequential multiple regression.

RESULTS

Men were 70 ± 7.2 years old and the survey was taken 47.9 ± 15.4 months after decision for therapy. The multiple regression analysis showed that, after controlling for potential covariates, internet usage (β = 3.28; p > 0.001), number of sources (β = 1.09; p > 0.01) and a lower level of informedness (β = 4.49; p > 0.001) independently predicted variability of anxiety. In addition, the 3‑way interaction (β = 2.03; p > 0.05) accounted for a significant proportion of variance. Overall, the model explained 30% of the criterion variance.

CONCLUSIONS

Our results show that many men with LPCa already use the internet as a source of information and that this online search is associated with increased disease-specific anxiety. It may be possible to reduce disease-specific anxiety and uncertainty if physicians advise their patients on the selection of reliable online sources.

Cancer-Diagnosed Individuals' Use of Television and the Internet as a Source for Peer Stories and Associated Emotional Responses

When people are confronted with a potentially life-threatening disease such as cancer, they are likely to feel an urgent need for information about the disease and support from peers. Studies have shown that the mass media contain a lot of experiential information (i.e., peer stories) about cancer, either from real individuals or from fictional characters. To date, most studies have focused on using the Internet for peer support. This study aimed to extend this line of research by investigating (1) whether cancer-diagnosed individuals use both television and the Internet to access peer stories, (2) whether exposure to these stories results in different emotional outcomes, and (3) whether this differs depending on gender. A cross-sectional survey among 621 cancer-diagnosed individuals in Flanders (Belgium) showed that both television and the Internet were used as a source for following peer stories. Respondents indicated feeling fearful and concerned when following peer stories on entertainment television, but following peer stories on online forums was associated with feeling supported. These different emotional responses could be the result of the differences between these two content categories (i.e., fictional versus non-fictional peer stories). Future research should further examine these relationships by investigating the role of mass media content and how different psychological coping styles and personality traits moderate these associations.

The Effects of Repetitive Information Communication through Multiple Channels on Prevention Behavior during the 2015 MERS Outbreak in South Korea

Although people nowadays engage in information communication repetitively through multiple channels during a public health crisis, the impacts of this communication on behavioral outcomes have not been fully examined. The present study empirically tests the effects of repetitive information communication through multiple channels (RICMC) on risk-prevention behavior. Additionally, the mediating roles of knowledge, perceived susceptibility, severity, response efficacy, and self-efficacy in the association between RICMC and risk-prevention behavior are examined. Analyses of online survey data (N = 1,036) collected during the 2015 Middle East respiratory syndrome (MERS) outbreak in South Korea revealed that RICMC was positively associated with MERS-prevention behavior. Furthermore, this association was mediated by perceived susceptibility, severity, and self-efficacy. Although response efficacy and knowledge were not significant mediators, RICMC was positively associated with all mediating variables. The implications, theoretical contributions, and limitations of this study are discussed.

Understanding middle-aged and older adults' first associations with the word "cancer": A mixed methods study in England

Objective

Cancer is still widely feared and often associated with death. Fatalistic beliefs adversely affect help‐seeking for cancer symptoms and engagement in cancer prevention. This study aims to understand middle‐aged and older adults' first association with the word “cancer” and their relationship with sociodemographic factors, cancer fear, and cancer information avoidance.

Methods

We conducted a cross‐sectional survey of 1464 community‐based adults aged 50 to 70 living in England in April 2015. First associations with cancer were measured qualitatively and analysed using content analysis. We used binary logistic regression to analyse associations between the most common first association of cancer and sociodemographic characteristics, cancer fear, and cancer information avoidance.

Results

Cancer was most commonly associated with “death” (26%). Respondents with lower levels of education, living in the Midlands or North of England where cancer mortality is higher, or with close friends or family members with a cancer history, were more likely to associate cancer with death. Cancer fear was significantly associated with death associations, but cancer information avoidance was not.

Conclusions

Despite improved cancer outcomes, middle‐aged and older adults often associate cancer with death. Further efforts to decrease fatalistic associations in this age group may be needed.

Electronic health record use among cancer patients: Insights from the Health Information National Trends Survey

Over 90% of US hospitals provide patients with access to e-copy of their health records, but the utilization of electronic health records by the US consumers remains low. Guided by the comprehensive information-seeking model, this study used data from the National Cancer Institute’s Health Information National Trends Survey 4 (Cycle 4) and examined the factors that explain the level of electronic health record use by cancer patients. Consistent with the model, individual information-seeking factors and perceptions of security and utility were associated with the frequency of electronic health record access. Specifically, higher income, prior online information seeking, interest in accessing health information online, and normative beliefs were predictive of electronic health record access. Conversely, poorer general health status and lack of health care provider encouragement to use electronic health records were associated with lower utilization rates. The current findings provide theory-based evidence that contributes to the understanding of the explanatory factors of electronic health record use and suggest future directions for research and practice.

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

OBJECTIVE

Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress.

DESIGN

Cross-sectional survey of 1258 population-based adults (58-70 years) in England.

MAIN OUTCOME MEASURES

Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education.

RESULTS

A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07-1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49-3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65-5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004-1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress.

CONCLUSION

Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.

Cancer Screening and Early Detection in Older People: Considerations for Nursing Practice

OBJECTIVE

To synthesize relevant issues in cancer screening for older people for nursing practice.

DATA SOURCES

Published scientific literature, clinical literature, and published cancer screening guidelines from the United States and Canada.

CONCLUSION

Nurses are caring for increasing numbers of older patients and, with this demographic shift, face increasing demands to address cancer screening and detection in both primary and specialty practice.

IMPLICATIONS FOR NURSING PRACTICE

Ageism, self-stereotyping, cancer fear and fatalism, and cancer survivorship experiences influence cancer screening and generate the need for improved awareness of these issues to advance nursing practice.

Reporting statistical analyses in peer review journal articles

As a regular referee for the Health Information and Libraries Journal, Richard Stephens--Winner of the 2014 Wellcome Trust Science Writing Prize--has been impressed by the science on offer in the Health Information and Libraries Journal. But he has also been struck by how often similar problems with statistical analysis reporting come up during the review process. Acknowledging that statistics can be scary, he advocates that they should be simply viewed as a means of communicating ideas. In this editorial, he provides some straightforward guidelines on reporting statistical analyses in peer review journal articles, highlights pitfalls to avoid and illustrates best practice to aim for.

La revelación del diagnóstico en oncología: una investigación transcultural Brasil-España

Objetivo: examinar aspectos transculturales de la revelación del diagnóstico de cáncer en pacientes brasileños y españoles. Método: Se realizó una investigación cualitativa en la que fueron entrevistados 28 pacientes en quimioterapia (14 brasileños y 14 españoles). El análisis de contenido identificó tres ejes temáticos: 1) Cómo fue revelado el diagnóstico; 2) Contexto en que el diagnóstico fue revelado y 3) Quién reveló el diagnóstico. Resultados: existen particularidades en la manera de revelar el diagnostico entre los dos países. En Brasil aún ocurre que el enfermo puede ser derivado a un oncólogo sin una explicación satisfactoria previa sobre su estado de salud. Aunque en los dos países existan relatos de comunicación de diagnóstico en el contexto apropiado (consulta), también ha aparecido revelación de manera informal (por teléfono) sin un ambiente adecuado para que el paciente sea acogido y tenga posibilidad de expresar sus miedos y sus dudas. Conclusión: es necesario invertir en la formación profesional para mejorar la habilidad de comunicación y educación en salud para tratar pacientes con cáncer.