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Biomedical subjects

F D Ashbury

Publications and source records attributed to F D Ashbury.

18 recordsLinked to original sources
PubMed1999

The Sociobehavioural Cancer Research Network: background and progress report.

The Sociobehavioural Cancer Research Network (SCRN) was established in 1994 by the National Cancer Institute of Canada (NCIC) with funding from the Canadian Cancer Society (CCS). The network was created to facilitate the development of behavioural science studies that would contribute to a fuller understanding of the cancer experience, from prevention through detection, treatment and post treatment (including palliative care). This article describes the nature of network research, the development and organization of the Sociobehavioural Cancer Research Network and the challenges it faces.

Adolescent↗
PubMed1998

One-on-one peer support and quality of life for breast cancer patients.

The Canadian Cancer Society's Reach to Recovery program provides one-on-one support for breast cancer patients that is delivered by breast cancer survivors. Professionally-led social support programs have generally been found to influence positively the quality of life of cancer patients. However, there is a lack of evidence on the benefits of one-on-one peer support programs. An evaluation of the Reach to Recovery program was completed in 1995 to determine if cancer patients who received the program were satisfied with the program and to determine if participation in Reach to Recovery affected the quality of life of program participants compared to patients who did not receive the program. We found that Reach to Recovery program participants were generally satisfied with the program they received and that the program has incremental benefits to the quality of life of patients with breast cancer. Peer-led, volunteer breast cancer support programs can be effective in enhancing the quality of life of breast cancer patients.

Adult↗
PubMed1998

A Canadian survey of cancer patients' experiences: are their needs being met?

Cancer patients (n = 913) who received treatment within the previous 2 years were interviewed to quantify reports of symptoms associated with cancer, measure the impact of symptoms on lifestyles, document experiences with accessing information and treatment for cancer and its symptoms, and record attitudes about the level of care received. Cancer patients were primarily recruited through newspaper ads placed throughout Canada and asked to complete a self-report questionnaire. Patients called a toll-free number and were interviewed to ensure eligibility. Most respondents were female (66%) with breast cancer (64%). Prostate cancer (40%) was the most common diagnosis among males. Almost all respondents (94%) reported experiencing one or more symptoms. Fatigue and anxiety were the most frequently reported symptoms (78% and 77%, respectively). Fatigue was most likely to be self-rated as moderate to severe and was most likely to interfere in normal daily activities. Respondents who experienced fatigue reported a more frequent use of healthcare services (including complementary therapies) than those who did not experience fatigue. Half of the respondents reported trying to find information on fatigue, but only half of these said they had obtained information. The most helpful sources of information were nurses, specialists, and other cancer patients. Respondents were more likely to be dissatisfied with their treatments for their symptoms than for their cancer. This survey indicates that most cancer patients experience symptoms related to the disease and its treatment. The most prevalent symptoms are fatigue and anxiety; fatigue is the most debilitating.

Adult↗
PubMed1998

Survey of Canadian doctors' attitudes to cancer staging.

OBJECTIVE: To collect opinions on the value of cancer staging, the impediments to realizing comprehensive staging and the support that may exist for providing stage information to cancer registries. DESIGN: The National Cancer Institute of Canada and the Canadian Committee on Cancer Staging have conducted an opinion survey. Opinions were sought about who should be responsible for allocating the stage, what criteria should be used to alter staging classification and whether population-based registries should contain comprehensive staging data. SETTING: The survey involved 1748 practising cancer specialists representing a cross section of Canadian physicians involved in the treatment and assessment of cancer patients. RESULTS: The overall response rate was 44.4%. Respondents gave broad support to the universal recording of cancer stage in Canada with 75.2% to 78.6% stating that staging is extremely useful for research, cancer statistics and caring for patients. Most respondents (98%) considered that all new cancer patients should have a specific stage assigned at the time of their first definitive treatment, and 78% believed that the clinician responsible for treating patients should determine the stage of cancer. A high proportion (73% to 81%) of respondents considered staging to be extremely important to define disease extent, make treatment decisions, estimate prognosis, facilitate consistent management and to compare results of treatment. The respondents consider lack of adequate information from pathology and imaging reports as barriers to staging. Only a small proportion of respondents were familiar with the organizations responsible for promoting and developing staging classifications. CONCLUSIONS: The Canadian survey showed strong support for universal staging and for the development of a central coordinated effort to promote cancer staging in Canada.

Academies and Institutes↗
PubMed1998

The consultation to develop a national strategy for cancer staging in Canada.

The lack of uniform recording of stage is a continued barrier to the success of cancer control activities. To review the role of staging, in 1997 the Canadian Committee on Cancer Staging (CCCS) of the National Cancer Institute of Canada (NCIC) formalised a national Consultation initiative with the input of Canadian oncology leaders and international experts on staging. A document was created from prior background work by the Committee and pre-circulated for comment. The document described the importance of cancer staging to patient care, epidemiological and clinical research, and cancer control programs. The document was refined through an iterative process over much of a year which included a formal workshop of the participants and other meetings. The Consultation reaffirmed, with evidence, the central role of staging in all aspects of cancer management. The report of the Consultation, endorsed by the Board of Directors of NCIC, included the following recommendations: 1) the recording of TNM stage by the treating physician should be a standard of care for every cancer patient in Canada where TNM applies, 2) the Canadian Council on Health Services Accreditation should include the TNM stage for every cancer patient as a requirement for hospital accreditation. In conclusion, this process represents an effective method for raising awareness about important medical issues such as staging which are fundamental to the management and control of cancer.

Academies and Institutes↗
PubMed1998

Issues in the implementation of cancer staging in Canada.

All sectors of the cancer control community in Canada agree that cancer staging is useful, and that stage should be assigned to every new case. At present, however, staging is not always recorded in the patient's records and treatment patterns and outcomes are rarely reported in terms of stage. This paper discusses what needs to be done to promote the use of staging in Canada. It is concluded that multifaceted programs of interventional continuing education (CE), tailored to meet the needs of the particular institution, offer the best prospect of success but the necessary organizational structure and information systems have to be put into place in advance. Implementation programs should be based on a thorough evaluation of the particular needs of the institution or community, and should be evaluated carefully in a few institutions before an attempt is made to disseminate them more widely. We recommend a phased approach to implementation which will first target institutions that already have the necessary infrastructure, i.e., provincial cancer centres. Demonstration of the feasibility and value of staging in that setting is seen as a means of promoting the adoption of staging in other institutions.

Academies and Institutes↗
PubMed1997

Development of an instrument to measure cancer screening knowledge, attitudes and behaviours.

The development of a comprehensive survey instrument to measure the knowledge, attitudes and behaviours of the general public with regard to cancer screening was the goal of this project. A thorough review of the literature was undertaken, and existing survey instruments were identified and organized according to type of cancer screening behaviour being measured; question foci (predisposing, enabling and reinforcing factors); and survey implementation protocol. A comprehensive survey instrument was developed with the intention that, if feasible, the survey of cancer screening behaviours could be implemented nationally by telephone. Separate survey instruments were developed according to sex. Focus groups were held across Canada to determine the comprehensiveness of the survey items; ease of understanding and ability to respond; feasibility with respect to possible sensitivity of some of the question items; and general implementation issues (e.g. length, sex of interviewer). This paper reports on the qualitative portion of the project. Our study supports the use of qualitative methodology for instrument development and implementation.

Canada↗
PubMed1997

Knowledge, attitudes and behaviours concerning cancer screening in Canada.

The Advisory Committee on Cancer Control funded a one-day workshop to discuss the surveillance of knowledge, attitudes/beliefs and behaviours concerning early cancer detection in Canada. Participants considered the need for such national surveillance and related methodological issues. Some exploratory work has been conducted in this regard. Results were presented from an inventory of existing survey questions and a summary of established cancer screening guidelines. There was overall agreement on the utility of collecting details of early cancer detection behaviours and their determinants. Explicitly, participants identified a need for site-specific information, highlighting cancers of the prostate and colon/rectum, as well as recognizing a need for qualitative information regarding the determinants that enable early cancer detection behaviours.

Canada↗
PubMed1997

Perspectives on Reach to Recovery and CanSurmount: informing the evaluation model.

The Canadian Cancer Society requested that the Centre for Behavioural Research and Program Evaluation of the National Cancer Institute of Canada evaluate Reach to Recovery and CanSurmount, 1-on-1 peer-support programs that provide information and support to individuals with cancer and their families. Key informant interviews (with program participants and volunteer visitors) were conducted to gather qualitative data and to help us develop a framework and tools to evaluate these programs. We found that 1) there are program objectives from the perspective of volunteers and participants in addition to those outlined in the program materials; 2) there are variations in how the programs are delivered and how patients or family members are recruited into the program; and 3) there is evidence that Reach to Recovery and CanSurmount volunteers are in a unique position to deliver the programs, either because they have personally experienced cancer or have family members who have had cancer. We describe the key informant exercise developed for this evaluation project and present the results of preliminary data-gathering activities.

Breast Neoplasms↗
PubMed1997

Focus groups with cancer patients: toward a more comprehensive understanding of the cancer experience.

Six focus groups of 58 individuals (30 women and 28 men) were held in 3 Canadian cities to help develop a survey instrument to be implemented nationally to identify cancer patients' experiences with cancer: treatment, symptoms and symptom management. Patient participants had different cancer diagnoses, but their experience with cancer had been within the year preceding the study. Our intent was to identify as many themes as possible to allow for comparison of different experiences in a national survey. This paper reports on what was learned substantively from these focus groups and discusses the methodological contribution of focus groups in developing survey tools.

Adaptation, Psychological↗
PubMed1995

Occupational repetitive strain injuries and gender in Ontario, 1986 to 1991.

Repetitive strain injuries (RSIs) in Ontario were examined with respect to gender for the period 1986 to 1991, using data from Ontario Workers' Compensation Board systems. Technical issues surrounding analysis of workplace injuries and theoretical suggestions raised by the data are discussed. Analyses revealed that the risk of RSIs for women is greater than that for men. Furthermore, women receive compensation benefits because of RSIs for a longer period than do their male counterparts, which may indicate a longer-term effect of RSIs on women.

Cumulative Trauma Disorders↗
PubMed1995

Charting the NCIC's future: stakeholder support for identified options.

The National Cancer Institute of Canada (NCIC) conducted a survey of representatives of its stakeholder populations (members of the cancer research and control communities, past and present NCIC grantees, senior administrators in academic institutions, NCIC governing committee representatives and major partners) to get input on proposals to restructure the NCIC's research programs. The survey results demonstrate support for changes that are likely to significantly alter how the NCIC operates as well as the programs it sponsors. The results suggest support for increasing the percentage of NCIC funds allocated to the Individual Operating Grants area and for changing the NCIC's programs and operating procedures. While there was widespread support for an NCIC-sponsored regional development initiative, many issues remain unresolved, such as what type of cancer research to develop within the provinces.

Academies and Institutes↗
PubMed1995

Issues for interpreting external stakeholder feedback on restructuring NCIC's research programs.

The National Cancer Institute of Canada surveyed members of its stakeholder groups on a number of issues pertaining to restructuring research programs. While it was hoped that the survey would ensure input from its primary stakeholder groups and thereby facilitate decision-making on critical issues like distribution of funds and research awards, there is reason to believe this may not have occurred. Some of the stakeholder groups seemed to be over-represented in the respondent population and the effect of this on the results was therefore examined. Analysis revealed several important issues: 1) a clear definition of who constitutes a "stakeholder" needs to be developed when stakeholder input-gathering is being contemplated; 2) multi-faceted strategies need to be developed to gain input from stakeholders; 3) potential sources of bias can emerge from the various techniques used to gather feedback from stakeholders; and 4) a clear outline of how the feedback is to be used in the decision-making process needs to be determined.

Academies and Institutes↗
PubMed1995

Focus group methodology in the development of a survey to measure physician use of cancer staging systems.

Accurate classification and staging of cancers enables physicians to select appropriate treatments, to evaluate outcomes of health management more reliably, to compare and interpret statistics reported from various institutions on a local, regional, national and international basis more consistently and to assist exchanges of information between different centers of treatment. This paper examines group interview methodology to develop the first-ever survey of Canadian cancer care specialists pertaining to staging systems. It is shown how the responses provided by participants contributed to the formulation of testable hypotheses and shaped the development of survey questions. As well, experiences are shared regarding the technical issues that arose using the focus group technique with physicians. In conclusion, there is a brief discussion of how the use of staging classification systems might be understood from the perspective of diffusion theory and social marketing (i.e., how information about cancer staging has been communicated and disseminated.

Canada↗
PubMedDate not supplied

Prostate cancer screening in the midst of controversy: Canadian men's knowledge, beliefs, utilization, and future intentions.

Despite controversy about prostate cancer screening, administrative data show that the use of prostate specific antigen (PSA) testing in Canada has increased. This study sought to determine awareness and knowledge of prostate cancer and screening, use to date, and future intentions to have a digital rectal examination (DRE) and PSA test among Canadian men aged 40 and over. Data were collected through a Canada-wide cross-sectional random digit dial telephone survey of 629 men. Awareness of DRE and PSA, use to date, and future intended use varied with age and education. Although only 9% of respondents had had PSA testing for screening, future intentions to undergo this test were higher than use to date. Knowledge of prostate cancer and screening controversies was low, and men received more information about PSA from the media than from doctors. Men would, therefore, benefit from age- and education-specific information regarding the factors to consider in making an informed choice about prostate cancer screening.

Adult↗