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Biomedical subjects

A B Jensen

Publications and source records attributed to A B Jensen.

7 recordsLinked to original sources
PubMed1992

[Psychosocial factors and breast cancer. A review].

Cancer of the breast is the commonest from of cancer of women in Denmark and the incidence is increasing. At present, a series of risk and prognostic factors are recognised. These are primarily related to the endocrine system. Other factors, including the significance of psychological and social factors, have been investigated. A review of the literature concerning the significance of psychological and social factors as risk and prognostic factors, respectively, reveals that the methodological problems in these investigations are considerable and multifarious. On the basis of a review of the literature, it is concluded, that there is no proof that psychosocial factors influence the disease of cancer of the breast. Nevertheless, certain evidence exits in the literature suggesting a connection between inhibition of aggression and an introverted personality and the development of cancer of the breast while, in some investigations, ability to cope has a certain significance as a prognostic factor. Investigations of psychosocial intervention as the actual antineoplastic treatment are very few and the results are difficult to interpret. It may be concluded that no basis exists to justify employment of psychosocial intervention as an actual form of treatment with the object of improving survival.

Breast Neoplasms↗
PubMed1991

Psychosocial factors in breast cancer and their possible impact upon prognosis.

Breast cancer is the most common cancer form in women. Numerous biological factors have now been identified and accepted as important risk factors and prognosticators. Psychosocial factors are also considered to be of probable importance. A review of the literature studying these factors reveals major methodological problems in evaluating data: small sample size, retrospective design, lack of cross-referencing for other important factors, cross-sectional studies instead of longitudinal studies, and insufficient statistical analysis. Regarding psychosocial factors, some of the most valid studies indicate that the risk of getting breast cancer may be connected with difficulties in expressing feelings, especially ones of aggression; while coping strategy, amount of stress, and level of activity, seem to be of possible influence to the prognosis. A possible connection between psyche and the immunological system has been proposed, but there has been little data so far. Although a series of studies have shown some influence of psychosocial factors on breast cancer, the methodological problems are so large as to leave open the question whether psychosocial factors have any impact upon the disease.

Breast Neoplasms↗
PubMed1990

[Informed consent. Historical background and current problems].

At present, informed consent is essential before patients can participate in clinical trials. The fact that a doctor asks the patient for informed consent is an expression of respect for the patient's right to make decisions about his own body. The request is made in recognition of the fact that optimal treatment can only be ensured by means of clinically controlled trials. The need for regulation of research arose at the beginning of the present century when pharmacological development accelerated. The Nürenberg Declaration was elaborated after the second world war and, subsequently, the Helsinki Declarations I and II. In these, directives are established for clinical research and for the rights of participants. A number of conditions make it difficult to fulfill these intentions. It may be difficult to ensure that the patient has adequate basic knowledge. The patient may feel that he is in a state of dependence on the doctor which influences his possibility to choose freely. Confidence between doctor and patient may be undermined if the patient is requested to participate in randomization for choice of treatment. Doctors know too little about how valid information can be ensured.

Ethics, Medical↗
PubMed1990

[How can sufficient information be ensured in clinical trials at an oncology department?].

It is difficult to comply with the intention that the patient gives consent to participation in a clinical trial on the basis of complete information. Reasons for this are the doctor's defective knowledge about processes of communication and his desire to protect the patient, and sometimes also himself, from disagreeable information. Solution of these problems requires more knowledge about theories of communication and crises and improved planning in how to provide this information. The patient's possibility of understanding the information on which he can base an independent decision may be improved by offering several conversations, improved presentation of the written information, the presence of a relative at the informative conversation and supplying the patient with a contact person from the staff for further information. It is concluded that more structured informative procedures are necessary in the individual departments in order to ensure that the patient receives sufficient information before giving qualified consent.

Clinical Trials as Topic↗
PubMed1990

[Written information in clinical trials at an oncology department].

On the basis of a model for communication, a series of requirements are established for the content and form of written information given in connection with clinical trials. Fourteen texts employed in an oncological department are reviewed. The clarity as expressed by the readability index (lixtal) is found to be considerably less than desired. A series of examples are presented which either make reading difficult or are such that the patient does not receive adequate and relevant information. In particular, information about alternatives to participation in the trial and the possibilities for feedback for the patient are not mentioned. Finally, proposals are made for how the doctor can ensure that the written information is adequate and readable.

Clinical Trials as Topic↗
PubMed1990

[Verbal information in clinical trials at an oncology department].

Prior to participation in clinical trials, patients must give their consent on the basis of information from the doctor. The content of the information is defined in the Helsinki Declaration. Information given in an oncological department was investigated and the patients were interviewed about the information obtained. The problems associated with the informative interviews with the patients were that these were frequently unstructured, that the patients were more concerned with their illness and treatment and that doctors had done too little to ensure that the patients had understood the information. It was most difficult for the doctors to provide thorough information about side-effects and disadvantages. Patients had greatest difficulty in understanding the principle of randomization. The patients' main reason for participation in the trial was the hope for therapeutic benefit. In departments where clinical research is undertaken, constant attention is required for how information on clinical trials is best given.

Aged↗