Biomedical subjects
Publications and source records attributed to D P Funch.
Several crude indicators of social stress and social involvement were used to explain survival among 283 women with breast cancer. The relationships of some stress and involvement indicators to survival are apparent; the data provide evidence that social stress decreases and social involvement increases the length of time breast cancer patients survive.
This study focused on the relationship of objective and subjective stresses to survival from breast cancer. The potential mediating roles of social support and age were also considered. This prospective study involved 208 white female breast cancer patients diagnosed between 1958 and 1960. At the time of diagnosis, subjects were interviewed regarding objective and subjective stress and social support present in the 5-year period preceding their diagnosis. Twenty years later, survival was calculated. The relationships between stress and survival were examined for three age groups: 15-45, 46-60, and 61 and older. Objective stress was related to survival for the oldest group while subjective stress was related to survival for the youngest group. Neither stress was related to survival for women aged 46-60. Social involvement was independently related to survival although it was not a mediator in the stress-survival relationship. Using the entire sample, stage of cancer at diagnosis was the best predictor of survival. However, when women aged 46-60 were eliminated from the analysis, stress and social involvement accounted for twice as much variance in survival as stage.
A survey of 509 family physicians in New York State was conducted to assess opinions about mammography and use of mammography in screening asymptomatic women of different ages. Findings indicate that most family physicians believe that mammography is an effective procedure for detecting breast cancer in its early stages, but many do not utilize mammography as a screening procedure in their own practices. The major deterrents to the use of mammography in screening asymptomatic women relate to concerns about the safety and reliability of the procedure, the low probability of detecting breast cancer through screening, the patient's willingness to accept a recommendation to have a mammogram, and cost. The results from this study point out the need to better educate primary care physicians about the use of mammography in screening for breast cancer, especially in regard to its safety and reliability.
The relationship between support and short-term recovery from breast surgery was examined retrospectively in 151 female breast cancer patients who were 3-12 months postoperative. Subjects were interviewed regarding the extent to which 3 forms of support (social, professional, financial) were available. Two indices, representing physical recovery and psychological adjustment, were generated. Patient characteristics (age, education, prior health status, and life stress following surgery) and clinical indicators of disease severity (stage, type of mastectomy, adjunct therapy, and time elapsed since surgery) were controlled. Social and professional support were significantly positively related to psychological adjustment. Financial support was significantly positively related to physical recovery. Implications of these findings for future research are discussed.
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A study was conducted to assess attitudes of women with breast cancer following their participation in a health outcome interview survey. The majority of the sample indicated that the interview was easier than expected and one reported being inconvenienced by the interview; 94 percent indicated they were glad to have participated and 58 percent felt they have received some personal benefit. There was no evidence of distress resulting from participation.
Using a single-subject design, two methods of treating nocturnal bruxism were evaluated. Neither technique was successful; both resulted in a rebound effect when treatment was stopped. In addition, the role of anxiety in bruxing behavior was evaluated. Contrary to most theoretical beliefs, bruxing resulting from anxiety was not as important as "anticipatory" anxiety resulting in bruxing.
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This paper considers the association between socioeconomic status (SES) and survival from breast and cervical cancers, two major health problems for women. For both cancers, lower SES women appear to have poorer survival. Factors which may account for this are discussed, including biological and nutritional factors. Major emphasis is placed on early detection since this appears to play a critical role in the survival differential. Factors which act as barriers to early detection among poor women are considered, including those related both to the health behaviors of the poor and to the health care system available to the poor.
This study of 154 men and 152 women with cancer of the colon or rectum addresses the lag between the first recognition of symptoms and the securing of definitive diagnosis and treatment. Total treatment delay is divided into two categories: patient delay, or the lag between the patient's first recognition of symptoms and first physician contact; diagnostic delay, or the lag between the patient's first physician contact and treatment. The results do not support the contention that women are more prone than men to respond to cancer symptoms; women in this sample are not more likely than men to recognize and respond to symptoms and seek care. The results suggest that, among patients with cancer of the rectum, women are more likely than men to delay in seeking care. Among patients with cancer of the colon, women are more likely than men to experience diagnostic delay.
The stool guaiac slide test (SGST) is a relatively recent innovation in screening for colorectal cancer. The test detects occult blood in the stool that may indicate the presence of cancer. In recent years, the SGST has been widely promoted as a screening test to aid in the detection of colorectal cancer. However, data from public and mass screening programs indicate that many people are unaware of the test and that few have actually taken it. The findings from these studies suggest that many physicians may not be using the test in their medical practices. The literature on diffusion theory suggests that acceptance of an innovation is influenced by the potential adopter's perception of the innovation's relative advantages over those of the ideas it supersedes, its perceived complexity, and its compatibility with the existing values and practices of the receiver. This research examined these factors as they relate to use of the SGST among a sample of 131 family physicians in New York State. Eighty-two percent of these physicians reported that they provide guaiac slides to at least some of their patients to collect stool specimens at home. The test was reportedly more commonly used for older patients than for younger ones. The physicians' beliefs about the relative effectiveness of the test in detecting early-stage colorectal cancer, compared with the effectiveness of alternative screening tests, and their perceptions about patients' willingness and ability to do the test at home were found to be important factors distinguishing between physicians who said they used the test and physicians who did not. The findings from this study suggest that future efforts aimed at promoting the use o1 theSGST among primary care physicians should emphasize the relative merits of the test in comparison with those of alternative screening procedures, especially with regard to its effectiveness in detecting early stage cancers, its simplicity, and its acceptance by patients.