Use of multiple data sources in planning a smoking cessation program for a defined population.
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Biomedical subjects
Publications and source records attributed to B Rimer.
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The problem of cancer-related pain afflicts millions of people annually. The study described here was aimed at improving cancer patients' pain control through a planned patient education program. A randomized clinical trial with a Solomon Four-Group design was used to assess the effectiveness of a patient education intervention consisting of nurse counseling and printed materials. The sample included 230 cancer patients. One month later, patients in the experimental group were more likely to have taken their pain medicine on the correct schedule and to have taken the correct dosage. The experimental group also was significantly less likely to report stopping the medicine when they felt better. In addition, they were significantly less worried about tolerance and addiction to pain medicines. Forty-four percent of the experimental group compared to 24% of the control group reported no or mild pain at the posttest.
While patient accrual for this study is not yet complete, it appears that the intervention may be helping patients to feel more in control over their pain, take the correct medication dosage and take action to prevent side effects. At this point, the experimental subjects seem much less worried about tolerance to pain medications. The early results suggest some sociodemographic differences in response to pain which, if they persist, should probably be considered as factors in designing patient education programs.
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Cancer now attacks one in three Americans, resulting in one in six deaths. Yet, until recently, few patient education programs were directed toward cancer patients. This review examines the status of cancer patient education and suggests future directions. We focus on several aspects of cancer patient education, including needs assessments and programs in treatment, rehabilitation, and continuing care and evaluation. The most comprehensive patient education programs are those directed toward patients in active treatment; one of its tasks is to help patients manage treatment side effects. A major component of rehabilitation programs is counseling patients to help them cope with the effects of cancer. Many patient education programs have performed evaluations; most reflect difficulties in one or more areas, such as selecting appropriate measures or accruing adequate sample sizes. We recommend several directions for the future, including the use of appropriate measurement tools, adequate sample sizes, multimodality programs with incorporation of psychological techniques such as relaxation training and guided imagery, and assessment of the impact of patient education programs on costs.
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The authors tested an empirical definition of comprehension and investigated the relationship between comprehension, retention, attitudes, beliefs, and behavioral change in response to a persuasive health message. The study used a randomized post-tests only design with one experimental and one control group. A booklet about exercise was given to experimental group participants in their homes. They were interviewed immediately after reading the booklet and one month later. Control group participants were interviewed at both times without exposure to the booklet. The authors found that participants who were able to operationalize key concepts related to the exercise message were the most likely group to have performed the recommended behavior according to self-reports. Measures of recognition and recall were not significantly related to behavior, but measures of psychological-operational meaning (defined as the learner's ability to use the information and relate it to his/her own life) were related significantly to self-reported behavior. The authors also examined the relationship of comprehension to other variables, such as attitudes, beliefs, and behavior. The study's results support the hypothesis that comprehension is a necessary but not sufficient precursor of behavior. Implications for both program design and measurement are discussed.
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The present investigation sought to determine (1) the impact of a single session stress management/coping intervention (problem-solving training; PST) versus a general health counseling (GHC) control condition on breast self-examination (BSE) adherence among relatives of newly diagnosed breast cancer patients, and (2) whether women with heightened perceived risk of breast cancer and/or cancer specific distress at baseline were more likely to improve their BSE adherence following PST. The participants were 510 women age 20-75 who had at least one first-degree relative with breast cancer. All of the participants completed a baseline telephone interview, an intervention (PST versus GHC), and a 3-month follow-up telephone interview. The results revealed a 36% overall improvement in BSE adherence, with no significant between-group difference in improvement (chi 2 = 0.03, p = 0.87). The logistic regression analysis of improvement in BSE adherence revealed a statistically significant cancer-specific distress by treatment interaction (p = 0.04). Among women who received PST, those with high levels of cancer-specific distress were two times more likely to improve in BSE adherence than women low in cancer-specific distress. There was no effect of cancer-specific distress in the control condition. These results suggest that women with a family history of breast cancer who have high levels of distress may be most likely to benefit from behavioral coping skills intervention to promote adherence to breast cancer screening.
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