PubMed Health⌕ Search

Biomedical subjects

C Eiser

Publications and source records attributed to C Eiser.

At least 55 records · Page 3Linked to original sources
PubMed1997

Diet, smoking and exercise: interrelationships between adolescent health behaviours.

A questionnaire measuring smoking status, exercise and dietary behaviour was administered to 932 high school pupils during regular classroom periods. Pupils were taken from three year groups which included 327 year 8 (12-13 years), 313 year 9 (13-14 years) and 292 year 10 (14-15 years). Pupils also indicated whether they could recall classroom teaching on 15 food- and health-related issues. Scores were derived representing self-reported frequency of eating foods that were high in fat, and fresh fruits and vegetables. Smoking was found to be associated with lower levels of exercise, consumption of less fresh foods and greater consumption of fatty foods. In addition, consumption of fresh foods was found to be positively correlated with exercise. These findings have implications for the organization of school-based health education efforts and suggest that health education programmes need to adopt an integrated approach rather than treat health behaviours in isolation from each other.

Adolescent↗
PubMed1997

The role of monitoring in determining quality of life following treatment for a bone tumor.

Interviews were conducted with 34 young people who had previously been treated for a malignant bone tumor around the knee. These interviews focused on the impact of treatment on activities and perceptions of the risk of recurrence and need for future surgery A coding schema based on a "monitoring-blunting" framework was adopted (Miller, 1995). Quality of life was assessed using a generic and disease-specific measure. Based on interview data, respondents were categorized as negativistic monitors, adaptive monitors, and nonmonitors. There were no differences between groups in terms medical indicators (number of operations). Negativistic monitors reported poorer quality of life compared with the other two groups. There was no increase in nonmonitoring with time since diagnosis as reported in previous work. It is suggested that patients' self-ratings of quality of life are related to the way in which they monitor information and this may be independent of clinical function. Clinical implications, especially in terms of how potentially threatening information about late-effects of treatment are given to patients, are discussed.

Journal Article↗
PubMed1996

Clinic audit for long-term survivors of childhood cancer.

Follow up for survivors of childhood cancer is considered essential in order to document any continuing impact on growth, fertility and other systems, as well as provide appropriate care and information to individuals themselves. Appropriate follow up needs to take into account the survivors' own views about reasons for attendance and perceived satisfaction with the services provided. Information was sought from 93 survivors (more than five years from diagnosis) and 68 of their parents regarding current attendance, understanding of the purpose of the clinic and satisfaction, and future preferences. Patients' main reasons for attending were to gain reassurance that they were well and information about the disease. There were some discrepancies between the types of information patients would like from clinic attendance and what they remembered being given. Parents were more positive than patients. Our data suggest that (i) knowledge in survivors is poor and (ii) it may be possible to define a subgroup for whom less frequent follow up is appropriate. A key component of care must involve education of patients, both about their past and the implications for future health.

Adolescent↗
PubMed1995

Routine stresses in caring for a child with cystic fibrosis.

Difficulties experienced by mothers caring for a child with cystic fibrosis were assessed. Difficulties were categorized as: (1) developmental, which included tasks generic to all families (bedtimes, socialization, siblings and communication with others); and (2) illness, which were especially pertinent to the care of the child with cystic fibrosis (mealtimes, physiotherapy and home-based medical care). Age differences were found in stresses associated with developmental routines, with mothers of younger children reporting more difficulties. With regard to illness routines, more difficulties were reported for children in better health (higher Shwachman scores). The data suggest that parents experience increasing difficulties in implementing home-based medical care where the child is in better health. Clinic staff need to be more aware of these difficulties and target information to parents appropriately.

Activities of Daily Living↗
PubMed1995

Parents' attributions about childhood cancer: implications for relationships with medical staff.

Improvements in therapy have resulted in increasing numbers of children being successfully treated for cancer. However, the aggressiveness of therapy and uncertainty about prognosis are associated with many adverse effects, psychological as well as physical, for both the child and family. This study investigates family coping with treatment in relation to attributions about cause and responsibility for onset of the disease. We interviewed parents of 30 children with cancer (28 mothers and 23 fathers) about their attributions of causality, and perceptions of responsibility for the diagnosis and care of the child. Coping strategies which were found to be helpful were assessed using the Coping Health Inventory for Parents (CHIP). Fathers were more likely than mothers to accept that there was no known cause for the child's illness. Fathers who blamed doctors for failing to diagnose the condition found medical staff less helpful up to 2 years later. The theoretical importance of blaming others more than oneself is discussed, along with practical implications for services in paediatric oncology.

Adaptation, Psychological↗
PubMed1995

Skin cancer attitudes: a cross-national comparison.

A questionnaire concerning attitudes towards skin cancer, sun exposure and general environmental issues was administered to 132 holiday-makers on a beach in south-west England and (in translation) to 142 visitors to another beach in north-west Italy. Following the Janis & Mann (1977) classification of strategies for coping with decision conflicts, subscales were derived measuring tendencies to 'avoid' thinking about environmental issues, to 'bolster' prior attitudes (by playing down the seriousness of the risk of skin cancer while attending to the pleasures of sunbathing), and to be 'vigilant' concerning risk information and the need for specific protective behaviour (e.g. sunscreen use). The British scored higher than the Italians, and women higher than men, on vigilance, but there were no gender or nationality differences on the other subscales considered as a whole. Responses were also related to the covariates of age and self-reported vulnerability to sunburn. Those who showed less concern with environmental issues also tended to play down the risks of skin cancer and be less vigilant with regard to self-protection. It is suggested that health promotion should address both cultural norms concerning exposure to the sun and people's intuitive notions about their relative personal vulnerability.

Adult↗
PubMed1995

Development of a measure to assess the perceived illness experience after treatment for cancer.

The development of a scale to measure perceived illness experience in young people with cancer is described. Areas of concern were first identified through semistructured interviews conducted with children and adolescents. As a result, 78 items were generated to cover the main areas identified (physical appearance, interference with activity, peer rejection, integration in school, manipulation, parental behaviour, disclosure, preoccupation with illness, and impact of treatment). These items were rated (on five point scales) by 41 patients (mean age 14.6 years) and 35 of their parents. Measures of physical functioning (symptoms, functional disability, and restrictions) and psychological functioning (symptoms) were included for validation purposes. Test-retest reliability was calculated on the basis of ratings made by a subsample of parents on two separate occasions. A 34 item scale was constructed with four items in each of the areas identified above, except for physical appearance (n = 2). The scale has adequate internal reliability and validity. There were significant correlations between parents and their children on all subscales except for illness disclosure and impact of treatment, suggesting that parents may be less reliable informants for their children in these contexts. The scale has potential use in clinical contexts, in evaluating the psychosocial impact of different treatment regimens, and as an outcome measure in intervention work.

Adolescent↗
PubMed1995

Quality of life in type II diabetes: evaluation and applications.

Issues of quality of life (QOL) have often been considered for patients with insulin-dependent diabetes mellitus (IDDM, type I diabetes). Daily blood glucose monitoring and need for self-injections pose an obvious threat to the attainment of QOL, as does concern about long term complications. In contrast, non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes) may be considered less severe, and has attracted less research interest. In fact, type II patients may also be aware of their heightened vulnerability to physical complications, as well as being affected by the need for heightened vigilance and attention to diet and exercise regimens. Issues associated with the theory and development of QOL measures are discussed largely in relation to type I diabetes and cancer. Generic measures have advantages in allowing comparisons to be made across different disease groups, and are, therefore, often favoured by health economists. In contrast, disease-specific scales are more sensitive to changes in treatment regimens, and may therefore be the instruments of choice in evaluating new treatments. In general, there has been less attention paid to how the meaning of QOL changes throughout the lifespan, and our review of the literature therefore emphasises a developmental perspective when considering the processes through which diabetes may affect an individual's QOL. Measures which, at the least, take into account changes in meaning of QOL throughout the lifespan need to be developed.

Age Factors↗
PubMed1994

Making sense of chronic disease. The eleventh Jack Tizard Memorial Lecture.

Three phases in psychosocial research for children with cancer are identified. These phases reflect changing fashions in theoretical perspective and determine the questions asked and the way in which professionals and families "make sense" of the disease experience. First, (1950s and 1960s) information about cancer was not shared with children and families were prepared for the inevitability of death. Second, (1970s and 1980s), the focus shifted from "dying" to "living" with a life-threatening condition. Information became more open. Currently, there is still greater emphasis on "living" with cancer. Attention has also shifted to the psychological needs of the long-term survivor.

Adaptation, Psychological↗
PubMed1993

Prescribed versus unrestricted carbohydrate diets in children with type 1 diabetes.

The diets of 53 children over 8 years of age with diabetes mellitus were examined by 24 h recall. Thirty-seven had been on prescribed carbohydrate diets while 16 had been on an unrestricted carbohydrate diet since diagnosis. The mean intakes of energy (prescribed 9.1 MJ, unrestricted 9.0 MJ, p = 0.66), carbohydrate (prescribed 259 g, unrestricted 251 g, p = 0.64), fat (prescribed 99.8 g, unrestricted 98.2 g, p = 0.84) and fibre (prescribed 29.2 g, unrestricted 31.0 g, p = 0.42) were not significantly different between the two groups. Both groups showed similar distribution of carbohydrate through the day and considerable day to day variation in their carbohydrate intake (coefficient of variation, prescribed 14.5%, unrestricted 14.1%, p = 0.87). Those on prescribed diet had a mean carbohydrate intake which exceeded their prescription by 36%. Both groups had above average fibre intake suggesting that qualitative advice was being followed. There were no significant differences between the two groups in metabolic control (HbA1 prescribed 12.4%, unrestricted 11.9%, p = 0.23), body mass index (prescribed 19.8 kg m-2, unrestricted 20.4 kg m-2) or insulin dosage (prescribed 1 unit kg-1 day-1, unrestricted 0.9 units kg-1 day-1). This study has shown no differences between prescribed and unrestricted carbohydrate diets. Qualitative, rather than quantitative advice may be more appropriate in the management of Type 1 diabetic children.

Adolescent↗
PubMed1993

Coming of age with diabetes: patients' views of a clinic for under-25 year olds.

This study is both an evaluation of patients' perceptions of a diabetes clinic for under-25 year olds, and an assessment of experiences in transferring from a paediatric clinic. Sixty-nine patients with Type 1 diabetes (74% of the total clinic), including 41 females, completed evaluations of the clinic and recall of experiences in transfer. Mean age on transferring clinic was 15.9 (range 12-20) years. Paediatricians were perceived to emphasise family and social life, school or work progress; adult physicians tended to stress the risk of long-term complications, importance of exercise and need to maintain strict levels of glycaemic control. Our data suggest that transition to adult care can generally be achieved non-traumatically, but patients may perceive some difficulty because of different emphases and treatment advice favoured by paediatricians and adult physicians.

Adolescent↗
PubMed1993

Healthy children's understanding of their blood: implications for explaining leukaemia to children.

Explanations of leukaemia to children usually include details of blood function and structure. In study 1, 3-year-olds (N = 25), 4-year-olds (N = 25), and 8-year-olds (N = 27) were interviewed about their understanding of the properties of blood and any occasions when they remembered seeing blood. They were also asked whether other animals and objects had blood or not, and to give reasons for this. Children justified their decisions in three ways: only people have blood, they had seen blood on a particular occasion, or only creatures which shared a human property (walking or talking) could have blood. In study 2, an intervention to increase children's understanding of the function of different blood cells is reported. It was partially successful. Children who reported an incident in which they saw blood were more likely to recall information about the function of red cells, white cells and platelets compared with children who did not report a previous experience (p < .001). In terms of explaining leukaemia to a child, we conclude that explanations should build on previous experience, and not be based simply on chronological age.

Blood↗
PubMed1992

Adjustment to chronic disease in relation to age and gender: mothers' and fathers' reports of their childrens' behavior.

Investigated age and gender differences in adjustment to chronic disease in children suffering from one of five conditions: diabetes, asthma, cardiac disease, epilepsy, and leukemia. Ratings of adjustment and disease-related restrictions were obtained separately from mothers and fathers. Factor analysis of the adjustment scale yielded 6 subscales which differentiated between children in terms of age and disease type, and to a lesser extent, gender. Mothers' and fathers' ratings of adjustment and restrictions were comparable, though fathers made less differentiation on the basis of disease or age. For both parents, perceived restrictions of the disease were associated with poorer adjustment in the child, and this was particularly reflected on indices of peer relations and work.

Adaptation, Psychological↗