Cancer practice最新文献

purpose: The primary goal of this study was to identify the needs for, the interest in, and the feasibility of the implementation of an Internet-based cancer services web site. Additionally, group differences (racial, patient vs caregiver, or rural vs urban) were identified that might influence the implementation of such a project.

description of study: Patients with cancer and caregivers (N = 319) in the waiting rooms of a cancer center located within a southeastern medical university completed questionnaires regarding their interest in Internet-based services. Topics included the likelihood of using Internet-based services, interest in home healthcare services delivered via a personal computer, and knowledge about and use of the Internet.

results: Results indicated that most patient and caregiver respondents were interested in Internet-based cancer-related services such as information related to treatment (80%), conversations with physicians via the Internet (70%), and online support groups (65%). In addition, respondents reported that they would be likely to use such services (70%) and were interested in home healthcare services delivered via personal computers (60%). No group differences were found across ethnic groups, geographic settings, and patient status (patient vs caregivers) on these variables. Minorities, older individuals, and less educated individuals were less likely to have knowledge of and to have used the Internet.

clinical implications: Patients with cancer and their caregivers are interested in supplementing in-person services with Internet-based services relating to their cancer treatment. Special efforts need to be made to reach ethnic minorities, the elderly, and those with less education with Internet-based programs.

purpose: In an effort to mitigate the negative psychological sequelae of a cancer diagnosis and cancer treatment, efforts have been made to explore a variety of psychosocial issues and interventions. This article describes the provision and preliminary evaluation of a novel psychosocial service delivery, a residential “retreat” program called Tapestry, which is run under the aegis of the established cancer care community in Alberta, Canada.

overview: Retreat programs offer a novel way to provide psychosocial support for those persons who are living with cancer. The retreats are unique in the provision of a respite and the opportunity to address the isolation and other existential issues arising from a cancer diagnosis. The program described in this article has provided such a service six times per year since 1998. The intervention is described, and preliminary evaluation data are presented.

clinical implications: Cancer care has begun to move beyond a solely biomedical paradigm toward a more holistic ethos in service delivery and research orientation. While the face value of and demand for such programming continues to grow, few residential psychosocial programs are offered under the auspices of conventional cancer care centers, and little work has been done to examine the nature and possible efficacy of retreat programs as a valid forum for psychosocial service delivery.

purpose: The purpose of this study was to examine the influence of heuristic reasoning on women's perceived risk for developing breast cancer, and to test for an expected bias in the direction of optimism that is predicted by recent research on human cognition.

description of study: In total, 770 women recruited in community settings were surveyed regarding cancer screening behavior and their perceived risk of developing breast cancer.

results: Most women perceived their risk of breast cancer to be lower than that of other women (3:1), confirming the expected bias toward optimism, and this finding was not attributable to the personality trait of optimism. Women following mammography guidelines showed greater optimism that their risk was low. Cancer knowledge and education diminished unwarranted optimism. Women with a history of benign breast disease, with a female relative with breast cancer, or both overestimated their risk. All findings suggest that heuristic thinking is being used to estimate personal cancer risk.

clinical implications: Clinicians should expect women to be optimistic about their personal risk of developing breast cancer. As a result, women may put off breast cancer screening or delay the evaluation of breast symptoms that may signal breast cancer. Helping women to understand their relative risk is an essential part of a health promotion visit.

purpose: The indirect morbidity/disability costs of breast cancer may be rising as a consequence of the growth in the population of long-term survivors. This study was conducted to test whether women who have survived breast cancer for at least 5 years experience long-lasting or continuing economic consequences that are attributable to their disease.

description of study: A group of 105 women who initially had been treated for breast cancer approximately 5 years before were interviewed to obtain data on economic, demographic, and health changes in the period since diagnosis. An age-matched and work-matched group of 105 women without cancer also was interviewed to obtain the same data for the same time period. Key changes in the economic position of subjects and their families were measured, including changes in work effort, pay rates, and annual earnings of working women and changes in household earnings, income, and assets of all women.

results: These preliminary empirical findings suggest that breast cancer exacts an economic toll from long-term survivors. In particular, survivors who were working at the time of their diagnosis experienced significantly larger reductions in annual market earnings over the 5-year study period than did working control subjects. These losses appear to arise mostly from reduced work effort, not changes in pay rates. Also, changes in total household earnings were lower for survivors, suggesting the presence of family adjustments to the disease. However, no significant differences were detected between the groups in changes in total income or assets over the study period.

clinical implications: Clinicians and policy makers must seek ways to minimize the indirect economic losses that are attributable to breast cancer.