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Biomedical subjects

C C Gotay

Publications and source records attributed to C C Gotay.

33 records · Page 2Linked to original sources
PubMed1992

Assessing quality of life in head and neck cancer.

Comprehensive assessment of the impact of head and neck cancer goes beyond traditional biomedical outcomes to include quality of life. This paper examines the methods used in reported studies on quality of life in head and neck cancer patients with respect to definitions, approaches to measurement, and types of findings. Analysis reveals little consensus in defining or assessing quality of life, although deficits in patient well-being were well-documented. A number of current efforts to develop and validate quality of life instruments specific to cancers of the head and neck have been reported. Future research should be sensitive to the issue of defining quality of life; a definition which includes both patient perceptions and objective functioning in a number of areas is advisable. Investigators should build on recent and ongoing efforts at instrument development and make efforts to incorporate quality of life assessment in clinical trials of cancer treatments. The distinctive aspects of head and neck cancer illustrate the importance of considering characteristics of the patient population in quality of life research and also the way that quality of life data can contribute to the multidisciplinary team of caregivers.

Data Interpretation, Statistical↗
PubMed1992

Building quality of life assessment into cancer treatment studies.

Quality of life is increasingly recognized as an important outcome of cancer treatment. However, quality of life research poses considerable problems in design and implementation. This article provides guidelines for the preparation of phase III therapeutic protocols that include quality of life assessment. The guidelines emphasize the distinct requirements of quality of life research and provide specific recommendations for the questions that need to be addressed in protocol development.

Clinical Trials as Topic↗
PubMed1991

Accrual to cancer clinical trials: directions from the research literature.

Although randomized clinical trials are the predominant method used to evaluate cancer therapies, only a small proportion of potential participants actually enter onto trials. This paper analyzes the research literature on accrual to cancer therapy trials. The research shows that nonparticipation is influenced by physician and patient variables, as well as by characteristics of the specific protocols. Trials design, especially pre-existing treatment preferences, pose significant problems for physicians and patients. Intervention strategies have focused on alternate trial designs, improving the informed consent process, and increasing knowledge about trials. Additional research should focus on the perspectives of patients who accept and decline trial participation and on interventions designed to affect accrual. Future studies need to be sensitive to patient quality of life considerations as well as practical and ethical issues.

Attitude of Health Personnel↗
PubMed1988

The long-term impact of a training program in maxillofacial prosthodontics.

A follow-up survey of trainees in a National Cancer Institute-sponsored program in maxillofacial prosthodontics was conducted. Information about the trainees' current professional activities indicated that the majority work in private practice or a dental school, are primarily involved in clinical work or teaching, and see few cancer patients. Inadequate reimbursement and lack of collaboration with surgeons were cited as barriers to involvement in cancer patient care. It is suggested that barriers to applying training expertise in actual practice settings require emphasis in the planning and curricula of training programs.

Career Choice↗
PubMed1988

Factors associated with enrollment in an employee fitness center.

Employee fitness programs may be evaluated by comparing program participants with nonparticipants on program outcome variables. This study was designed to identify how participants in an employee fitness program may selectively differ from nonparticipants. Joiners were more likely to have engaged in prior fitness activity, to consider fitness a high priority, and to have more positive attitudes about keeping fit. Traditional factors such as demographic or health status variables were not different between joiners and nonjoiners. Although the fitness center was not systematically selecting the more fit employee, participants were different from nonparticipants in terms of attitudinal and behavioral factors which reflect a health promotion orientation.

Adult↗
PubMed1985

Why me? Attributions and adjustment by cancer patients and their mates at two stages in the disease process.

This research investigated how cancer patients at early and advanced stage disease (N = 73) and their mates (N = 39) attributed causality for the disease, their levels of adjustment and the relationship between attributions and adjustment. Data were collected through semi-structured home interviews. Results indicated that the largest numbers of individuals cited chance as the cause of the cancer, although many reported that they had not asked themselves the question, 'Why me?'. Adjustment measures indicated, in general, more similarities than differences between groups. Attributions were not significant predictors of adjustment. It is suggested that not making strong causal attributions may be adaptive for cancer patients and their families.

Adaptation, Psychological↗
PubMed1985

Palliative home care nursing: nurses' perceptions of roles and stress.

This exploratory study investigated perceptions of palliative home care nurses regarding their roles. Results are based on structured interviews with all ten nurses providing care in a home care program for dying patients. Most nurses agree that nursing the terminally ill is a distinctive kind of nursing, requiring particular capabilities, and providing its own unique frustrations and satisfactions. While nurses experienced stress, especially the nurses who had spent a shorter period of time working for the program, they had a variety of ways to cope with stress. Suggestions for hospice program planning and future research are presented.

Alberta↗
PubMed1984

The experience of cancer during early and advanced stages: the views of patients and their mates.

Problems, coping mechanisms and problem resolution were assessed in 112 individuals: patients with early stage cervical cancer or pre-cancer (N = 42) and their mates (N = 19), and patients with advanced stage breast or gynecological cancer (N = 31) and their mates (N = 20). The most common source of concern for all groups was the disease itself; the men were also more likely than the patients to be disturbed by the possibility of the women dying. Taking firm action was the most frequently-mentioned coping strategy; information-seeking was also common among the early stage groups, and religious faith often cited by the advanced stage respondents. Analysis of a particular problem--fear of cancer--showed different coping strategies to be predominant; mates, in contrast to patients, were likely to take direct action and advanced stage groups more likely to discuss their fear of cancer with others. Problem resolution did not vary from group to group. Overall, the similarities among reactions of early and advanced stage patients and mates were more striking than differences, indicating the profound impact of cancer over the course of the disease on patient and family alike.

Adaptation, Psychological↗
PubMed1983

Home care for the dying: homemakers' perspectives.

Homemakers are important members of the health care team providing hospice care at home, yet there is little information about their views and experiences. This paper summarizes findings of a survey of homemakers working with a newly-developed program for providing home care for dying patients and their families. Results indicate that homemakers perform multiple roles, which they report tend to be more demanding physically and psychosocially than other kinds of homemaking. Being able to provide comfort in a time of extreme need is satisfying to homemakers, although frustrations exist as well. Implications for program planning and future research are discussed.

Alberta↗
PubMed1983

Models of terminal care: a review of the research literature.

Relatively recent recognition of the particular needs of those who are terminally ill has directed attention to the most humane approaches to the provision of care. The strengths and weaknesses of a number of models for the delivery of terminal care, such as hospital-based programs, freestanding facilities, home care services, and day care programs, are reviewed and the relevant research literature is critically evaluated with respect to methodology and findings. Although many shortcomings in research design and a lack of comparability between studies are noted, the data on hospice care generally indicate positive outcomes. Future research considerations are proposed.

Day Care, Medical↗
PubMedDate not supplied

Social support and cancer screening in African American, Hispanic, and Native American women.

PURPOSE: Minority women have higher rates of mortality from breast and cervical cancers and lower rates of utilization of screening tests than white women. Innovative ways to increase screening in these populations are needed urgently. This report examines the effectiveness of screening interventions based on social support for breast and cervical cancers in African American, Hispanic, and Native American women. OVERVIEW: Despite the availability of mammography, clinical breast examination, and Papanicolaou smears, many women do not follow recommendations to obtain these tests. Further, many of the traditional approaches to health education have not been effective in minority populations. Additional strategies to promote screening for breast and cervical cancers are needed, particularly for women who, by virtue of language and/or culture, are outside the mainstream. Nontraditional approaches, or social support interventions, may be particularly effective in promoting cancer screening and reducing cancer mortality in high-risk minority women. CLINICAL IMPLICATIONS: Programs that use social support offer the potential to draw on the strengths of a population--the ties between individuals, the importance of the family, and traditional cultural values--to improve screening for breast and cervical cancers in minority groups. In developing a social support intervention, healthcare providers should consider the similarities and differences among populations; collaborate with representatives of the target community; incorporate social support within hospitals and clinics; and include social support as an essential component of the clinical encounter.

Black or African American↗
PubMedDate not supplied

Perceived cancer causes: use of complementary and alternative therapy.

PURPOSE: The objectives of this report are to describe beliefs about general and personal cancer causes among patients with cancer who use and do not use complementary and alternative medicine (CAM), to compare these beliefs with current epidemiologic knowledge, and to explore associations between these beliefs and choice of CAMs. DESCRIPTION OF INTERVIEWS: The authors conducted a semistructured interview with 143 patients with cancer, who were identified via the Hawaii Tumor Registry and had participated in a survey on CAM use. By design, the majority of interviewees (85%) were CAM users. A qualitative data analysis was performed. RESULTS: Genetics, environment, and diet were among the most common perceived general causes of cancer, whereas psychosocial factors were by far the most common perceived personal causes. CAM users were more likely than nonusers to name environment, immune system, and stress as cancer causes. Compared with the epidemiologic literature, study participants were less likely to mention tobacco use and more likely to consider environmental exposures, psychosocial factors, immunologic mechanisms, and physical injury as causes of cancer. Furthermore, the interviews suggest that causal thinking may be related to the type of CAM used. CLINICAL IMPLICATIONS: Given the discrepancy between popular cancer theories and current scientific knowledge, the challenge for the healthcare provider is to listen and try to understand the patient's beliefs about cancer etiology. Understanding the patient's beliefs about their disease is important in providing the support and information they need to make effective decisions about their medical care.

Adult↗