Biomedical subjects

Carmen Radecki Breitkopf

Publications and source records attributed to Carmen Radecki Breitkopf.

13 recordsLinked to original sources

PubMed2006

Anxiety symptoms during pregnancy and postpartum.

This cross-sectional study compared the distribution of anxiety symptoms among pregnant, non-pregnant, and postpartum women of lower socioeconomic status. Participants were 807 women who were pregnant (24-36 weeks), postpartum (2-8 weeks), or not pregnant. Anxiety and depressive symptoms were assessed by the state-trait anxiety index and the Beck depression inventory, respectively. English and Spanish versions of the instrument were available. Group differences in anxiety were evaluated using analysis of variance. Multivariate regression was performed to evaluate differences in anxiety while controlling for marital status, education, race/ethnicity, employment, cohabitation, income, parity, history of depression/anxiety, and depressive symptoms. Anxiety scores were lower among postpartum women relative to pregnant and non-pregnant women (both P < 0.001), who did not differ (P = 0.99). After controlling for depressive symptoms and patient characteristics, anxiety remained lowest among postpartum women. Additionally, history of depression/anxiety and depressive symptoms were significant predictors of anxiety in the multivariate analysis. Comparatively low anxiety and depressive symptoms were observed among women who were 2-8 weeks postpartum. Anxiety symptoms that occur postpartum may not appear until later in the postpartum period.

Adult↗

PubMed2006

Rape acknowledgment and postassault experiences: how acknowledgment status relates to disclosure, coping, worldview, and reactions received from others.

Many rape victims are unacknowledged. These victims do not label their experience as rape; instead they give the experience a more benign label, such as a miscommunication. The current study examined the relationship between victims' acknowledgment status and post-assault behaviors, moving beyond prior research. Analyses of covariance were conducted comparing the post-assault experiences of unacknowledged and acknowledged college rape victims (n = 256), controlling for differences in victims' assault characteristics, multiple victimization, and post-traumatic stress symptoms. Results supported that unacknowledged and acknowledged victims differed in their coping, disclosure, belief in justice, and receipt of egocentric reactions following disclosure. Implications for future work examining the dynamic interplay among assault characteristics, sexual scripts, acknowledgment status, and post-assault factors are discussed.

Adaptation, Psychological↗

PubMed2005

The relationship between source of sexual information and sexual behavior among female adolescents.

INTRODUCTION: The relationship between the source of sexual information and adolescent sexual behavior is not well understood. MATERIALS AND METHODS: As part of a larger study, 892 sexually active female adolescents between 15 and 18 years of age completed a paper-and-pencil survey which assessed discussions about sexual intercourse, contraceptive use and condom use among friends and family members and their own sexual behavior. Multivariate logistic regression analyses were performed to examine associations while controlling for key demographics. RESULTS: Adolescents who had never used condoms were less likely to report having had discussions about sexual intercourse with their friends [adjusted odds ratio (AOR) = 0.2]. Discussions about condom use among friends and family members were associated with condom use in the past 3 months, with adolescents who used condoms at least half of the time being more likely to report hearing discussions relative to adolescents who never used condoms (AORs 2.0-3.8). Furthermore, the number of sexual partners was related to whether the adolescent had heard discussions among her family about condom use; the higher the number of sexual partners, the more likely the adolescent was to have heard discussions. For adolescents reporting 2-3, 4-5 and 6 or more partners (relative to one partner), the AORs were 1.7, 2.3 and 2.7, respectively. DISCUSSION: Adolescents exposed to information about condom use among the primary individuals in their lives are more likely to be engaging in this behavior themselves.

Adolescent↗

PubMed2005

Patterns and perceptions of ecstasy use among young, low-income women.

A significant number of young, low-income women experiment with ecstasy outside of club or rave settings. The current study examined patterns and risk factors of ecstasy use among this group of women. A cross-sectional survey was conducted among 696 women aged 18 to 31 who sought gynecological care from two university clinics in southeast Texas between December 1, 2001, and May 30, 2003. Fifteen percent of participants reported ever using ecstasy. Of those, over 90% used it at a friend's home. Compared with women who used only marijuana or other illicit drugs, ecstasy users were more likely to be white, use a larger number of other drugs, be willing to use drugs in the future, and have more friends who used drugs. Fewer ecstasy users strongly disapproved of adult drug use than users of other illicit drugs. Future interventional efforts should target young, low-income women to prevent future experimentation with illicit drugs.

Adolescent↗

PubMed2005

Pelvic Organ Support Study (POSST) and bowel symptoms: straining at stool is associated with perineal and anterior vaginal descent in a general gynecologic population.

OBJECTIVE: The purpose of this study was to evaluate the association of constipation symptoms and anal incontinence with vaginal wall and pelvic organ descent in a general gynecologic population. STUDY DESIGN: In this multicenter, cross-sectional study, 1004 women attending routine gynecologic healthcare underwent pelvic organ prolapse quantification (POPQ) measurements, and were surveyed regarding anal incontinence, digitation, < 2 bowel movements (BMs)/week, and > 25% frequency of: straining, hard/lumpy stools, and incomplete emptying. Constipation scores reflected the sum of positive responses. Associations between POPQ measurements (Ba, C, Bp, gh+pb), constipation scores, and anal incontinence were evaluated using multivariable regression. RESULTS: Of 119 women with Bp > or = -1.00, 47% reported no constipation symptoms. Hard/lumpy stools (26%), incomplete emptying (24%), and straining (24%) were more prevalent; fewer women reported < 2 BMs/week (15%) or digitation (7%). Constipation scores were weakly correlated with Bp, gh+pb (both r < .1, P < .02). Women reporting > or = 2 symptoms had greater gh+pb measurements than women reporting 0 or 1 symptom (P = .03). Women with anal incontinence had greater gh+pb and gh values than women without anal incontinence (P < .01). POPQ measurements were regressed separately onto (1) total constipation scores, (2) dichotomized scores, and (3) individual symptoms, with BMI, age, number of vaginal deliveries (NVD), weight of largest vaginal delivery (WLVD), race, hysterectomy, study site, and income included as covariates. Total constipation scores and dichotomized scores were nonsignificant in all models. With regard to individual symptoms, straining at stool was significant in the models for Ba and gh+pb, with greater Ba and gh+pb measurements among strainers relative to nonstrainers. CONCLUSION: Most associations between bowel symptoms and vaginal or pelvic organ descent were weak. After controlling for important covariates, straining at stool remained associated with anterior vaginal wall and perineal descent.

Adult↗

PubMed2005

Poor knowledge regarding the Pap test among low-income women undergoing routine screening.

CONTEXT: Many women undergoing cervical cancer screening lack appropriate understanding of the Pap test. It is important to evaluate knowledge and informational needs about Pap testing among groups who may have difficulty accessing care or a relatively low likelihood of obtaining follow-up for an abnormal result, such as minority and low-income women. METHODS: A sample of 338 women undergoing cervical screening at two clinics in Texas completed a questionnaire measuring their knowledge of Pap testing and asking what specific information they would like to know about the test. Group comparisons and qualitative analyses were conducted. RESULTS: Women correctly answered an average of 8.7 out of 20 questions; the range was 0-17. Mean scores were higher among white women (10.2) than among blacks (8.4) and Hispanics (7.4), among women with more than a high school education than among their less educated counterparts (10.0 vs. 7.9) and among women with an annual household income of at least $10,000 than among those with a lower income (9.3 vs. 8.4). Knowledge scores did not differ according to Pap history. Open-ended questioning identified a need for information on the purpose of the test, exam procedures, abnormal test results and prognosis. CONCLUSIONS: Minority women and those of low socioeconomic status had poor understanding of Pap testing. Identifying misunderstandings in this vulnerable population and improving patient education on the most basic aspects of Pap testing may increase adherence to follow-up when abnormalities are detected.

Adolescent↗

PubMed2004

Correlates of weight loss behaviors among low-income African-American, Caucasian, and Latina women.

OBJECTIVE: To examine the prevalence and correlates of weight reduction behaviors among low-income women. METHODS: A total of 1,709 Caucasian, African-American, and Latina women aged 12-58 years attending a federally funded family planning clinic reported their weight loss behaviors during the past 30 days, including using diet pills, exercising, purging (vomiting, laxatives, diuretics), and dieting. Approximately 60% (n = 999) had a body mass index of 25 or greater. RESULTS: Overall, 35.3% (n = 603) of women dieted, 43.7% (n = 746) exercised, 15.1% (n = 258) used diet pills, and 4.3% (n = 69) purged. Only 14.8% (n = 253) of the sample reported both dieting and exercising. The odds of exercising for weight loss decreased as parity increased. Those who smoked currently or in the past were more likely than nonsmokers to report purging (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.2, 5.4). African Americans were least likely to diet or exercise compared with Caucasians and Latinas. Exposure to family members using diet pills (OR 4.6; 95% CI 3.2, 6.5), dieting (OR 2.1; 95% CI 1.6, 2.8), or purging (OR 5.6; 95% CI 2.7, 11.9) was associated with increased odds of performing these behaviors oneself. CONCLUSION: This research demonstrates that low-income women frequently use maladaptive strategies, such as diet pills and purging, to lose weight. Obesity and family exposure to these behaviors places women at increased risk of unhealthy behaviors. Interventions designed to reduce obesity must include precautions regarding the dangers of these practices. LEVEL OF EVIDENCE: III

Adolescent↗

PubMed2004

Effects of hormonal contraception on bone mineral density after 24 months of use.

OBJECTIVE: To measure the effect of 24 months of depot medroxyprogesterone acetate use on bone mineral density compared with oral contraception (pills) and nonhormonal contraception. METHODS: Women aged 18-33 years self-selected oral contraception, depot medroxyprogesterone acetate, or nonhormonal contraception (controls). Those selecting pills were randomized to formulations containing either 35 microg ethinyl estradiol and norethindrone or 30 microg ethinyl estradiol and desogestrel. Controls were frequency matched on age and race/ethnicity to hormonal contraception users. Dual-energy X-ray absorptiometry of the lumbar spine (L1-L4) was performed at baseline, 12 months, and 24 months. Percent change in bone mineral density was analyzed by using analysis of covariance, adjusting for age, race/ethnicity, weight-bearing exercise, calcium intake, smoking status, and body mass index. RESULTS: Of the 191 women making up the final sample, 86 used pills, 47 used depot medroxyprogesterone acetate, and 58 used nonhormonal contraception. Women using depot medroxyprogesterone acetate for 24 months experienced, on average, a 5.7% loss in bone mineral density, with a 3.2% loss occurring between months 12 and 24. On average, users of desogestrel pills experienced a 2.6% loss in bone mineral density after 24 months. Bonferroni-adjusted pairwise comparisons demonstrated that bone mineral density changes from baseline to 24 months among depot medroxyprogesterone acetate users differed significantly from changes experienced by either of the pill groups or the control group. Changes in bone mineral density among users of either pill did not significantly differ from each other or from controls. CONCLUSION: Loss of bone mineral density associated with depot medroxyprogesterone acetate use appears to be linear during the first 2 years of use. Shifts in bone mineral density among pill users were not significant when compared with controls.

Adolescent↗

PubMed2004

Psychological and sociocultural perspectives on follow-up of abnormal Papanicolaou results.

OBJECTIVE: To understand women's motivation to attend follow-up of an abnormal Papanicolaou (Pap) test by applying a general theoretical framework for voluntary behavior. METHODS: Semistructured, face-to-face interviews were conducted among 120 low-income, African-American, Caucasian, or Hispanic outpatients, aged 25-50 years, who presented for routine gynecologic care. Interview questions assessed social, cognitive, environmental, and emotional factors surrounding follow-up for an abnormal Pap test. Content analysis was performed. RESULTS: The majority of women (74%) described their attitude toward returning for a follow-up visit as favorable. Overall, knowledge regarding the significance of an abnormal result was poor, and misconceptions were common. Perceived barriers, consequences, and social influences associated with attending follow-up were qualitatively different across the 3 racial/ethnic groups. For example, African-American and Hispanic women expressed embarrassment more frequently than Caucasian women and were less likely to anticipate obstacles to attending follow-up. Furthermore, African-American women were the least likely to be influenced by others' opinions and to perceive difficulty in adhering to follow-up recommendations. For nearly all women, adequate communication with their provider was a key component of anticipated adherence. CONCLUSION: Clinicians may exert a positive influence on adherence among patients who experience an abnormal Pap test by engaging patients in a dialogue that accommodates the patient's sociocultural environment, explores concerns regarding the partner's reaction, emphasizes the importance of follow-up, provides a clear understanding of the process and timeline surrounding follow-up recommendations, and encourages the patient to anticipate obstacles to adherence and assists with solutions.

Adult↗

PubMed2004

The theoretical basis of stigma as applied to genital herpes.

This paper defines stigma and its characteristics, outlines strategies and consequences of stigma management, describes the theoretical basis of stigma, and offers methodological considerations for those applying stigma theory to the domain of genital herpes. Stigma is an interactional process, defined within societies, in which particular social identities are collectively devalued. The subjective experience of stigma may vary due to features associated with the stigmatizing condition (e.g. concealability, course, strain, aesthetic qualities, cause and peril). The interpersonal management of stigma may include secrecy, withdrawal, covering, informing or disclosing. Future research addressing herpes-associated stigma should benefit from theoretical frameworks including attribution theory, social-cognitive theory, preoccupation model of secrecy and the illness intrusiveness framework, although the difficulty in identifying and recruiting stigmatized individuals and the lack of domain-specific measures of herpes-related stigma remain barriers to progress.

Attitude to Health↗

PubMed2003

Reproductive correlates of depressive symptoms among low-income minority women.

OBJECTIVE: To estimate the prevalence of depressive symptoms among women of reproductive age attending family planning clinics across southeast Texas in addition to demographic and reproductive characteristics associated with these symptoms. METHODS: A retrospective, self-reported, paper-and-pencil survey designed to assess health and risk behaviors was administered to 4726 low-income suburban women, aged 12 and 40 years, attending a family planning clinic in southeast Texas. The survey contained a background and demographic section in addition to six sections addressing health risk behaviors. Women also completed the 13-item Beck Depression Inventory to assess depressive symptoms. RESULTS: A total of 11.8% exhibited mild symptoms of depression, 14.0% had moderate symptoms, and 4.8% had severe symptoms. Women were at increased risk of moderate to severe symptoms of depression if they were Hispanic, had not graduated high school, were unemployed, or currently smoked cigarettes. Sexual or reproductive characteristics associated with moderate to severe symptoms included two or more lifetime sexual partners, having used hormonal contraception before age 13, not using any birth control at last intercourse, having had a sexually transmitted disease, not having had sexual intercourse in the last 3 months or having had it under the influence of alcohol or drugs, and having heard a family member worry about contracting a sexually transmitted disease or discuss use of alcohol or drugs before sex. CONCLUSION: A large percentage of women experience moderate to severe depressive symptoms during their reproductive years. These symptoms are associated with numerous risk behaviors, including inconsistent use of birth control. Women's health care providers have the opportunity to provide a valuable service by screening for depressive symptoms.

Adolescent↗

PubMed2003

Complications associated with surveying medical student depression: the importance of anonymity.

OBJECTIVE: To evaluate students' attitudes and concerns regarding potential repercussions of completing the Beck Depression Inventory (BDI). METHODS: A survey based on focus group data was developed and distributed. RESULTS: One hundred and ninety-one of 400 surveys (48%) were returned. Of 160 students who remembered completing the BDI, 31 (19%) admitted to concerns about the research, and nearly 10% admitted to recording dishonest answers. CONCLUSIONS: These findings emphasize the importance of conducting anonymous assessments of medical students, particularly when assessing sensitive psychological states.

Adult↗

PubMedDate not supplied

A qualitative examination of the needs of families faced with the option of organ donation.

Fewer than half of families approached about organ donation provide consent. Identifying specific support needs of family members in these situations is critical to help them cope and for improving consent rates. This focus group study retrospectively investigated donor and non-donor family members' perceived social support needs while facing the death of their loved one. Implications for nursing care and other interventions are discussed for interested healthcare providers.

Adaptation, Psychological↗