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Biomedical subjects

B D Doan

Publications and source records attributed to B D Doan.

16 recordsLinked to original sources
PubMed1992

Psychologic adaptation of survivors of childhood cancer.

When adult survivors of childhood cancer were compared with their peers, survivors were found to be at least as well adjusted. Indeed, some evidence was suggestive of survivors having adaptive advantages in everyday life. The survivors reported significantly more positive affect, less negative affect, higher intimacy motivation, more perceived personal control, and greater satisfaction with control in life situations. Despite these apparent strengths associated with surviving childhood cancer, several specific problems were documented. Survivors were more likely than peers to have repeated school grades, to be worried about issues of fertility, and to express dissatisfaction with important relationships. The latter finding was interpreted as reflecting the high expectations of survivors for relationships, based on their difficult yet interpersonally rewarding experiences during times of illness.

Adaptation, Psychological↗
PubMed1992

Views of a general population on mass screening for colorectal cancer: the Burgundy Study.

BACKGROUND: The success of a screening program depends on a number of factors, including the validity of the test, its efficacy, its feasibility, and the rate of compliance. Thus, it is important to determine the factors influencing compliance to the screening test in order to obtain a high participation rate. METHODS: A mass screening campaign for colorectal cancer using the Hemoccult test was conducted in Burgundy, France. One year later, a questionnaire was mailed to a random sample of the population to assess the views of the general public (870 persons who had not completed the Hemoccult test, 750 persons who had a negative test, and 100 persons who had a positive test). The compliance rate of this survey was 32.2% among persons who had not completed the screening test, 88.2% among persons with a negative result, and 98.0% among persons with a positive result. RESULTS: The main reason for not participating was not wanting to know more about their health status (34.3%). Of the factors credited with encouraging persons to perform the test, the most important ones were the practitioner's explanations (55.7%) and the leaflet sent by mail (42.5%). The impact of the media campaign was weak. A small portion of the population (4.3%) said that they were very anxious while waiting for the results. Among persons with a positive screening test, only 1.2% regretted having taken it. Among those who took the test, 94.2% said they were ready to do it again; and among those who did not take it, 36.7% would accept it at a second screening. CONCLUSIONS: The data suggest that overall the Hemoccult is well accepted, that the campaign did not upset the population, and that it is worthwhile at the second screening to include those who did not participate in the first screening test.

Aged↗
PubMed1990

Heroic self-healing and cancer: clinical issues for the health professions.

Increasingly over the last few decades, persons with cancer are being cured or surviving longer. As a result, the popular press has given more attention to the possibilities for "beating" cancer. The role of personal control in overcoming cancer has been promoted via a heroic formula that includes positive thinking, healing imagery, and personal growth. Empirical support for a psychospiritual influence on cancer illness is tenuous. Nevertheless, the psychological implications of belief in such influence are important in their own right. In this paper, the positive and negative consequences for patients of popular conceptions of the heroic cancer survivor are explored. Clinical and ethical issues related to the health professional's responses to patients' belief in heroic self-healing are discussed, and a rationale is presented for adopting a non-judgmental, person-centered approach.

Attitude to Health↗
PubMed1990

Empowerment and persons with cancer: politics in cancer medicine.

Persons with cancer are likely to encounter a loss of personal control as a result of their illness experience. An empowerment perspective, which emphasizes the possibility of patients "owning their own lives", is useful for understanding the interpersonal and social dynamics of patients' loss of control and for guiding the development of strategies aimed at maximizing control. Because the factors influencing an individual's sense of control are multi-leveled, optimal empowerment occurs when strategies are employed at several levels of social organization. In this paper, a number of barriers to the empowerment of cancer patients are identified and strategies recommended to enhance patient empowerment in cancer care. The empowerment needs and strategies discussed here include: (a) the provision of optimal care, (b) the enhancement of individual patient power, (c) the development of a strong consumer voice in policy decision-making processes, and (d) societal attitude change.

Attitude↗
PubMedDate not supplied

[The foresight behavior of French general practitioners].

In France, "social insurance" is less comprehensive as concerns the independent workers that the salaried employees. Voluntary insurance is therefore a subject of crucial importance for physicians, the large majority of them being in private practice. In 1993, nearly 70% or 75% of French GP's are voluntarily insured against one risk or an other. The older generations have seemingly a lower providence level than the younger. As concerns the "vital" risks (death, disability) the insurance rate is higher among men. For the "minor" risks (e.g. income loss due to illness) women have a higher insurance rate. Effect of income appears for insurance against vital risks but it disappears when a certain income level is reached. Such a level does not exist as concerns the minor risks: the higher the income, the higher the insurance rate.

Adult↗
PubMedDate not supplied

[Health at cost? Meeting of the FICOSSER Inter-Center Collaborative Research Group on Health Cost Containment Policies (Barcelona, Spain, 19-21 April 1993)].

The Catalunyan Health Service describes its innovating approach based on the conventional bedday average cost for allocating resources to hospital. The model developed at the University of Newcastle, New South Wales, Australia, aims at reducing cost through quality improvement. The Center for Health Policy Research, University of Florida, USA, suggests a renovated DRG's model of reimbursement based on hospital outcomes. A typology of reimbursement to providers is designed by the National School of Public Health of Brazil. The health cost experience and the impact of co-payment policy in Korea is described by the Institute for Health Services Research of the University Yonsei in Seoul. The paper presented by the Australian National University, Canberra, tries to identify the factors contributing to curbing growth rate of health costs in Australia. Drug utilization in Poland is analyzed by the Department of Social Medicine of the Medical University of Lodz, Poland. The current reform of the Hungarian health system is described by the Department of Social Medicine of the Medical University of Debrecen, Hungary. The specific issues of a health system in a fast-growing economy, which however will be burdened by population aging in less than 3 decades, are analyzed by the Division of Health Care of the National University of Singapore. The Center for Health Policy Research of the American Medical Association displays economic calculations which show that, from the consumer's point of view, health costs are far from being too high. The Université de Bourgogne lays down the economic foundations for a containment policy based on professional ethics.

Cost Control↗
PubMedDate not supplied

[A decade of continuing medical education in France (1983-1993)].

Continuing education is not compulsory to medical doctors in France. However, nearly all of them make use of several means for knowledge and practice refreshment. Medical journals are the first rank, both for GP's and specialists. The two groups behave differently as concerns the other means. Medical specialists who, in France, can practice outwith or within hospitals, have their continuing education closely related to public hospitals. GP's prefer in general to base their own on means which are not related to hospitals: sessions organized by the profession, visitors from pharmaceutical firms... etc... There is a broad discrepancy between the use of an educational mean and its rating as first priority. However, as far as French GP's are concerned, medical journals and sessions organized by the profession are at the first rank both for utilization frequency and priority rating. Visitors from pharmaceutical firms are not rated at first priority--although they have a very high utilization frequency--but they obtain an interesting second rank rating. Age, sex and workload have each an effect on priority rating. In many cases, survey findings are not in line with conventional thinking on the matter.

Adult↗
PubMedDate not supplied

[New technological equipments and their economical impact in ambulatory care].

The 1st Part of the study, based on 3 opinion surveys among ambulatory care providers (French physicians in private practice) shows a steady increase of prescribed technological "acts". However, the number of physicians having high-tech devices in their office is much lower. Ownership is understandably less frequent than equipment leasing or renting. In the French context, turnover of physicians for using high-tech equipment is outpaced by turnover of patients: as a rule, general practitioners send their patients to the specialist's offices or to hospitals (in France, the specialists practice both in ambulatory and institutional settings). The 2nd Part of the study, based on 4,471 physicians' tax files, attempts to identify the investment behavior of doctors in private practice regarding new technological devices. The specialty and the obsolescence speed of the equipment play both an important role. However, the choice between renting/leasing and purchasing depends also whether the doctor has a long run or a short term perspective. Such a choice is clearly evidenced through the French mechanisms of income taxation. It explains why the doctor's annual income (gross or net) is not significantly related to his investment behavior.

Ambulatory Care↗