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Biomedical subjects

A Moyer

Publications and source records attributed to A Moyer.

13 recordsLinked to original sources
PubMed1999

Identifying older people in need using action research.

An ageing population has implications for community-based health promotion and disease prevention. There is concern about older people who do not fit into existing programmes and services yet need minimal support to maintain independence. A study was designed to develop approaches to gain access to this hard to reach population, assess needs and design and test interventions to integrate them into the community. The study, informed by theories of health promotion and social support, used action research methods. Participant observation documented in field notes, together with case notes and clinical assessments, provided a rich source of qualitative and quantitative data. This article discusses the needs assessment. Over a 3-year period, public health nurses linked with community groups in a predominantly francophone, urban community to identify the target group. Key characteristics of the target group included limitations with instrumental activities of daily living and low levels of social support combined with stressful life situations that challenged adaptation. Three patterns of inadequate support were identified.

Activities of Daily Living↗
PubMed1998

Clarification of the conceptualization and measurement of denial in psychosocial oncology research.

Denial represents an important area of study in individuals with cancer. It may be related to recognizing symptoms, seeking medical help, psychological adjustment to diagnosis and illness, and perhaps progression of the disease. However, denial has been defined theoretically and measured in a variety of ways. These differences are due to a lack of consensus as to whether denial is unconscious versus conscious, a trait versus a state, an indication of psychological disturbance versus a normal response to a life-threatening disease, or a broad versus a narrow concept. In addition, there is a lack of congruence between theoretical definitions and the operational definitions used in empirical studies investigating denial in the context of cancer. This inconsistency may be responsible for the mixed findings concerning the importance and function of denial in individuals with cancer. In this article, the ways in which denial has been conceptualized and operationalized are examined, and an overview of the research examining denial in cancer patients is provided. We recommend that future studies provide explicit definitions of denial, use multiple measures assessing different modalities and outcomes, measure denial at several times over the course of illness, and take into account aspects of the individual's situation to ensure that denial is not identified erroneously.

Adaptation, Psychological↗
PubMed1998

Evaluation of a midwifery birthing center in the Canadian north.

An evaluation of a midwife-operated community birthing center was conducted to identify whether it would be safe, cost-effective, and psychologically and socially satisfying for Inuit women in one community in the Northwest Territories. Two nurse-midwives provided antenatal and postnatal care to all pregnant women and delivered those designated as 'low risk' for complications. Another community similar in size but with no community birthing was used for comparison of the three indices. Data were gathered on reproductive histories and pregnancy risk profiles of all women giving birth in a one-year period. The financial costs were calculated for those women transferred out to hospital for delivery and compared with those who stayed in the community. Pregnant women and their partners in both communities, health staff, and community members were interviewed for their feelings and concerns about the birthing services. Preliminary findings suggest that with experienced midwives community births are safe. A minimum of 25 births is required in the community for this project to be cost effective. The women who had their infants in the community expressed satisfaction for a number of reasons.

Arctic Regions↗
PubMed1998

Patient participation in treatment decision making and the psychological consequences of breast cancer surgery.

Women in the early stages of breast cancer can be treated effectively with either modified radical mastectomy or tumor excision plus postoperative radiation therapy. Thus, breast cancer patients may be given a choice between these two modes of treatment. In some states, physician disclosure of such treatment alternatives for breast cancer is mandated by law. Despite the belief that patient participation in decision making is beneficial, the evidence is preliminary, although generally supportive. This study examined the extent to which patient participation in the choice of surgical options was related to psychological functioning, fear of cancer recurrence, and aspects of treatment satisfaction 3 and 13 months postoperatively. Few associations with degree of participation in treatment decision making or type of surgical treatment emerged after 3 months. After 13 months, however, women with greater levels of input into their treatment plan were more satisfied with their medical care, although they were not better off in terms of psychological functioning or fear of cancer recurrence. The positive effects of shared treatment decision making may be more closely related to aspects of longer term treatment satisfaction rather than a buffer against psychological distress resulting from breast cancer.

Adaptation, Psychological↗
PubMed1997

Psychosocial outcomes of breast-conserving surgery versus mastectomy: a meta-analytic review.

Effective breast-conserving surgical techniques for early-stage disease were developed to improve breast cancer patients' quality of life. The literature comparing the psychosocial sequelae of these newer treatments with mastectomy is ambiguous and shows an unexpected lack of substantial benefits. To clarify these inconsistencies, meta-analytic methods were used to summarize the findings of 40 investigations. Mean weighted effect sizes were calculated for 6 psychosocial outcomes. Modest advantages for breast-conserving surgery were identified for psychological, marital-sexual, and social adjustment; body/self-image; and cancer-related fears and concerns. Method of assignment to treatment and timing of assessment were relevant for some outcomes.

Adaptation, Psychological↗
PubMed1997

Support as experienced by patients with cancer during radiotherapy treatments.

Patients diagnosed with cancer are frequently prescribed radiation therapy. The treatment is a source of much anxiety and worry for patients and their families. Support, a highly valued intervention strategy in nursing, is believed to assist patients to adjust to stressful experiences. A qualitative study was conducted to determine patients' experiences of support while receiving radiotherapy. Data from 12 patients were analysed using the procedures and techniques of grounded theory. A substantive theory of support emerged which showed that support is an interpersonal process embedded in an array of social exchanges which involves encountering support, recognising support and feeling supported. Three main types of support are encountered: being there, giving help and giving information. It is a multifaceted concept and all types of support are seen as important. Actions are interpreted within the norms and expectations of a relationship and labelled as supportive by the recipient. Family and friends are the principal sources of all types of support. Professional support is mainly informational. The findings raise many questions, one of which is should there be a rethinking of the concept of support in nursing?

Adaptation, Psychological↗
PubMed1995

The effects of message framing on mammography utilization.

This experiment compared the effectiveness of gain-versus loss-framed messages to persuade women to obtain mammography screening. One hundred and thirty-three women 40 years and older and not adhering to current guidelines for obtaining mammography screening were assigned randomly to view either gain-framed (emphasizing the benefits of obtaining mammography) or loss-framed (emphasizing the risks of not obtaining mammography) persuasive videos that were factually equivalent. Attitudes and beliefs were measured before and immediately following the intervention. Mammography utilization was assessed 6 and 12 months later. Consistent with predictions based on prospect theory, women who viewed the loss-framed message were more likely to have obtained a mammogram within 12 months of the intervention. These findings suggest that loss-framed messages may have an advantage in the promotion of detection behaviors such as mammography.

Adult↗
PubMed1993

Cephalic phase insulin release in bulimia.

Cephalic phase secretions are associated with the sight, smell, and taste of food, as opposed to its postingestional consequences. These secretions are thought to influence metabolism and eating behavior. Cephalic phase insulin release (CPIR), in particular, might be related to hunger and overeating. It was hypothesized that bulimics, who often show endocrine abnormalities, may have an altered CPIR that, in turn, might be related to the precipitation and maintenance of binges. This study investigated whether (1) the profile or magnitude of the CPIR in bulimics differs from that of non-eating disordered controls, (2) food ingestion alters subsequent CPIR, and (3) mood and desire to binge are related to CPIR. Findings indicated little abnormality in bulimics' profile of insulin secretion. Although biological variables were not related to hunger or desire to binge, for bulimics, dysphoric moods were. The results may suggest more complex determinants of binge eating than physiological state alone.

Adult↗
PubMed1989

Caring for a child with diabetes: the effect of specialist nurse care on parents' needs and concerns.

One hundred and sixty parents of 10- to 18-year-old children with diabetes were interviewed using Hymovich's Chronicity Impact and Coping Instrument (CICI: PQ). Eighty-two parents had access to a specialist nurse service; 72 parents did not. Regardless of the age of the child or the duration of diabetes, parents expressed a need for advice and support with child care. Parents with a specialist nurse needed information on more topics tending to focus on activities of daily living and child development rather than physical care and illness. They were also more likely to seek and receive help from nurses. Their level of concern was greater and, it is argued, may be the price parents pay for greater awareness. The findings of this study suggest that a systematic assessment of parent coping is necessary if specialist nurses are to help parents in their role as primary health carers.

Activities of Daily Living↗
PubMedDate not supplied

Additional validation of a scale to assess positive states of mind.

OBJECTIVE: Numerous studies have linked stress and negative states to adverse health outcomes. However, in addition to engendering negative states, stress may impair capacities to experience positive states. Such failure to experience positive states may represent a risk factor for poor health in and of itself. The research reported here examines a brief, easily repeated measure of positive states of mind (PSOM) including: focused attention, productivity, responsible caretaking, restful repose, sharing, sensuous nonsexual pleasure, and sensuous sexual pleasure. METHOD: The PSOM Scale and measures of psychological distress, stress, and physical symptoms were administered in four independent samples: two samples of college students and two samples of pregnant women, one undergoing a potentially stressful medical procedure (amniocentesis). The relationship between PSOM scores and several conceptually related, but distinct, psychological variables was examined, controlling for the effect of social desirability where necessary. RESULTS: The range of scores on the items of the PSOM indicated that impairments of ability to have the relevant experiences did occur in the subjects who were experiencing stress. The overall PSOM Scale score consistently showed an inverse relationship with anxiety and with indicators of stress. In addition, lower scores on the PSOM Scale were associated with more somatic symptomatology. CONCLUSION: The results provide evidence that positive states of mind are linked to negative psychological states and are responsive to stressful events. The PSOM scale provides a useful, brief measure for research in stress and health.

Adaptation, Psychological↗
PubMedDate not supplied

Facilitating the shift to population-based public health programs: innovation through the use of framework and logic model tools.

Program planning and evaluation are critical steps in using a population health approach. This paper outlines how logic models have been adapted within a health promotion framework to guide public health programs and facilitate program description. It is important that we take the time to describe clearly what we are doing, reflect on practice and elaborate the conceptual base for the new public health programs so that we can evaluate the impact of our work. Ongoing research is required to identify appropriate and measurable indicators that capture the process, as well as the outcome, of population-based health promotion.

Canada↗