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Biomedical subjects

Deborah F Farmer

Publications and source records attributed to Deborah F Farmer.

4 recordsLinked to original sources

A qualitative exploration of the cancer experience among long-term survivors: comparisons by cancer type, ethnicity, gender, and age.

BACKGROUND: To elucidate meanings ascribed to the cancer experience by long-term survivors. METHODS: Semi-structured interviews were conducted with 58 cancer survivors (>15 years post-diagnosis). Respondents described how cancer affected their quality of life (QOL) generally and in 17 domains. Systematic content analyses were conducted to extract themes relating to meanings assigned to the cancer experience. Themes were analyzed by cancer type, gender, and age and confirmed using quantitative assessments of self-rated health and QOL. RESULTS: Four themes were identified: Personal Growth, That's Life. Relinquishing Control, and Resentment. Women more frequently acknowledged Personal Growth, and men more often indicated minimal impact on their lives (That's Life). Older survivors were disproportionately classified as That's Life and younger survivors as Personal Growth. No differences were observed by cancer type or ethnicity. Those who saw cancer as personal growth had the highest QOL, while those who resented cancer had the lowest QOL. CONCLUSIONS: Most long-term survivors retrospectively report that cancer either positively influenced their lives or had little long-term impact. Those who express Resentment report that pain, physical deformities, and social isolation significantly reduced their QOL. This qualitative study highlights how cancer survivors incorporate the cancer experience within their overall lives.

Adult↗

Cancer screening among Native Americans in eastern North Carolina.

The purpose of the study is to explore cancer screening predictors and practices among Lumbee Indians in eastern North Carolina. Interviewers from the community conducted phone interviews with 333 men and 456 women aged 40 and older randomly selected from the Lumbee Tribal roll as part of the Lumbee Diabetes and Health Survey. The survey has sections on demographic information and health conditions, family history of chronic conditions, and health behaviors. This paper reports on cancer screening behaviors. Rates of ever being screened for breast, cervical, prostate and colon cancer were relatively high compared with overall national rates. Predictors included younger age, better health, more education, and lifestyle factors such as engaging in regular physical activity and not smoking. Future research should focus on developing culturally appropriate campaigns to increase the frequency of cancer screening to conform to guidelines, and educational programs and interventions to reach Lumbee Indians most at risk for not being screened.

Adult↗

Smoking and incidence of diabetes among U.S. adults: findings from the Insulin Resistance Atherosclerosis Study.

OBJECTIVE: The objective of this study was to determine the association between smoking and incident diabetes among U.S. adults. RESEARCH DESIGN AND METHODS: The Insulin Resistance Atherosclerosis Study (IRAS) was a prospective study of the associations of insulin sensitivity and cardiovascular risk factors. We examined the relationship between smoking status categories (never, former, and current) and incident 5-year type 2 diabetes among 906 participants free of diabetes at baseline. We also considered the effect of pack-year categories (never, former <20 pack-years, former > or = 20 pack-years, current <20 pack-years, and current > or = 20 pack-years) upon diabetes incidence. RESULTS: Of current smokers, 96 (25%) developed diabetes at 5 years, compared with 60 (14%) never smokers. After multivariable adjustment, current smokers exhibited increased incidence of diabetes compared with never smokers (odds ratio [OR] 2.66, P = 0.001). Similar results were found among current smokers with > or = 20 pack-years with normal glucose tolerance (5.66, P = 0.001). CONCLUSIONS: Smoking shares a robust association with incident diabetes, supporting the current Surgeon General's warnings against cigarette smoking.

Adult↗

Challenges and innovations in enhancing adherence.

Adherence is a complex phenomenon involving interactions among the individual, the environment and the community. In an adherence workshop, a small group of investigators discussed their experiences with challenges and innovations regarding adherence gleaned from clinical research. This article summarizes the information and outcomes of that meeting. Guided by theoretical frameworks for understanding and promoting adherence, challenges in the areas of measurement, community-based research, and interventions were explored and innovations for meeting these challenges suggested. The article concludes with recommendations for enhancing the adherence agenda: (1) adherence research must have a well-defined conceptual and theoretical basis; (2) individual perceptions and social context of behavior must be incorporated; (3) research must be undertaken as a collaborative process involving participants and the community. Looking ahead, it is clear that if we hope to develop a new and integrated model of adherence, we must continue to advance theory through theory testing, with particular attention given to mediators and diverse samples. Moreover, an interdisciplinary agenda is necessary to set the stage for bringing together researchers from various disciplines and backgrounds with both participants and community representatives.

Clinical Trials as Topic↗