Biomedical subjects

G Padonu

Publications and source records attributed to G Padonu.

8 recordsLinked to original sources

PubMed2000

Predictors of participation in health care at menopause.

Patient participation in health care is widely advocated but little is known about the factors influencing patients' active participation. To learn whether attitudes and beliefs helped predict patient participation, 252 midlife women completed measures of self-efficacy, perceived barriers to participation, attitudes, subjective norms, and intentions following a decision to support intervention on menopause. Two months following the intervention, 63 women who had visited a health care provider returned questionnaires by mail regarding self-reported participation in the health care encounter and satisfaction with the decision about estrogen replacement therapy. The results were that self-efficacy (beta = .19; p < .05) significantly predicted intention to participate in the next health care encounter. Both patient intentions (beta = .40;p < .05) and perceived barriers (beta = -.27; p < .05) were significant predictors of self-reported participation. Active participation (beta = .42;p < .05) and attitude (beta =.25;p < .05) were associated with increased satisfaction with decision. Participation resulted in increased self-efficacy (beta = .30;p < .05). The conclusions were that midlife women who express more confidence in their ability to participate in their health care have greater intentions to participate. Women who experience fewer barriers to participation and have more intention to participate are more likely to report actively participating in a health care encounter, and self-reported participation and more positive attitudes toward participation are associated with greater satisfaction with decisions.

Adult↗

PubMed1999

Patient decision support intervention: increased consistency with decision analytic models.

BACKGROUND: Patient Decision Support (PDS) tools assist patients in using medical evidence to make choices consistent that are with their values and in using evidence about consequences of medical alternatives. OBJECTIVE: To evaluate a PDS intervention for perimenopausal hormone replacement therapy. We assessed the impact of the PDS on (1) consistency between the decision to take estrogen replacement therapy (ERT) or progesterone/estrogen replacement therapy (PERT) and the expected utility of treatment and (2) likelihood to take ERT and PERT pre- and postintervention. DESIGN: Content of the PDS was standardized. Randomized trial of three intensities of intervention: (1) brochure; (2) lecture/discussion; and (3) active decision support. SUBJECTS: Participants were perimenopausal community volunteers between the ages of 40 and 65 (n = 248). MEASURES: (1) Consistent with values (correlation between expected utility (EU) and likelihood of taking hormones); and (2) Likelihood to take hormone replacement therapy. RESULTS: (1) The brochure group was less consistent with the decision analytic model than the lecture/discussion and active decision support groups. (2) Influence on decisions: PDS tools increased the number of women certain about whether or not to take hormones. There were no differences among experimental groups. Of 99 women uncertain about ERT pre-PDS, 65% changed. Twenty-one (32%) decided against ERT and 44 (68%) decided for ERT. (3) More intensive interventions produced modest gains in a normative direction. CONCLUSIONS: PDSs using any of 3 formats reduce uncertainty and assist women to make informed decisions. Increased consistency with decision analytic models appears to be driven by better estimates of likelihood of outcomes.

Adult↗

PubMed1997

An educational intervention as decision support for menopausal women.

The purpose of this study was to develop and test a decision support intervention (DSI) to assist women to make and act on informed decisions that are consistent with their values in the area of menopause and hormone replacement therapy (HRT). Mode and intensity of intervention were tested in midlife women (N = 248), randomly assigned to one of three intervention formats: written information only, guided discussion, or personalized decision exercise. Data were collected over 12 months. Knowledge, decisional conflict, satisfaction with health care provider, and self-efficacy improved following intervention and were maintained for 12 months for all groups. Women's adherence to their own plans over 12 months was 59% (exercise), 76% (calcium intake), and 89% (HRT). Carefully written information is effective in promoting knowledge, adherence, and satisfaction among well-educated, interested women. It was concluded that women can understand complex information, including tradeoffs regarding treatment options. Women will adhere to their own plans, suggesting that consumer rather than provider plans may be the more appropriate gold standard for measuring adherence.

Adult↗

PubMedDate not supplied

Menopausal women as decision makers in health care.

The findings of a preliminary analysis of data from a study now being conducted to design and evaluate an educational intervention to aid women in becoming more effective decision-makers regarding menopause, self-care strategies, and hormone replacement therapy (HRT), indicate that the lack of attention to the symptoms and health effects of menopause has resulted in frustration and dissatisfaction among women health care consumers. Women in the menopausal years are not informed adequately nor empowered to participate in decision making around issues related to their own health. They do not have the information they want and they do not know where to get it.

Estrogen Replacement Therapy↗

PubMedDate not supplied

Patient satisfaction with health care decisions: the satisfaction with decision scale.

Patient satisfaction measures have previously addressed satisfaction with medical care, satisfaction with providers, and satisfaction with outcomes, but not satisfaction with the health care decision itself. As patients become more involved in health care decisions, it is important to understand specific dynamics of the decision itself. The Satisfaction with Decision (SWD) scale measures satisfaction with health care decisions. It was developed in the context of postmenopausal hormone-replacement therapy decisions. The six-item scale has excellent reliability (Cronbach's alpha = 0.86). Discriminant validity, tested by performing principal-components analysis of items pooled from the SWD scale and two conceptually related measures, was good. Correlation of the SWD scale with measures of satisfaction with other aspects of the decision-making process showed the SWD scale was correlated most highly (0.64) with "decisional confidence," and least with "desire to participate in health care decisions" and "satisfaction with provider." The SWD scale predicts decision certainty in this study. Use in an independent study showed that the SWD scale was correlated with the likelihood of patients' intentions to get a flu shot. Further investigation in relation to other health decisions will establish the utility of the SWD scale as an outcome measure.

Adult↗

PubMedDate not supplied

Social influences on Pap smear screening frequency.

Incidence and mortality rates of cervical cancer among Native American women is two to five times that of comparable Whites. Social and cultural differences contribute to this problem. We studied thirty age 40 and older American Indian women, half of whom had obtained at least one Pap in the past three years, the other half of whom had not. We asked: Do the two groups differ in their attitudes concerning Pap tests and those with whom they interact concerning Pap tests? and: Do they interact differently with different social groups concerning Pap tests? Data were obtained from chart audits and Given's Health Belief Questionnaire. The groups did not differ as to who they discussed Pap tests with or whose opinions they respected. They respected healthcare professionals most, family/friends less, and co-workers/others least. These findings suggest that the advanced practice nurse has an opportunity to improve Pap screening rates in this population.

Adult↗

PubMedDate not supplied

African-American women's attitudes and expectations of menopause.

INTRODUCTION: In this study, low-income perimenopausal African-American women were surveyed to determine knowledge of menopause and hormone replacement therapy (HRT). METHODS: A 92-item survey assessed perceptions of menopause and health risks to identify preventive strategies in this population. The nonprobability sample of 197 African-American women typically had incomes of < $15,000, age 46-55, high school education or less. RESULTS: Major findings were that African-American women (1) experienced expected levels of occurrence of symptoms, but perceived them as not very bothersome, (2) had a knowledge deficit related to menopause and HRT, and (3) had expectations about menopause that underestimated their lifetime risk of heart disease. CONCLUSION: The lack of knowledge about menopause, HRT, and lifetime risks of heart disease suggests that low-income African-American women need better information for decision making about prevention. However, this sample knew the rank order of major health risks. Health information to the public and culturally relevant patient education are critical prerequisites to any preventive behavioral strategies in this population. Further research should identify culturally based expectations of disease risk and efficacy of prevention strategy to tailor messages to particular subpopulations.

Adult↗

PubMedDate not supplied

The impact of ethnicity on attitudes and beliefs about estrogen replacement therapy among Michigan nurses.

This study investigates how a selected group of Black and White nurses perceived the risks and benefits of estrogen replacement therapy. The Menopausal Health Survey was developed as a mailed, self-administered survey to assess nurses' knowledge of estrogen's effects on osteoporosis and heart disease, and to assess nurses' attitudes toward estrogen replacement therapy. The findings suggest that given two samples of women with different ethinic backgrounds, but similar geographic locations, incomes, educational backgrounds, and health-seeking practices, there are distinct differences in knowledge about and perceptions of estrogen replacement therapy. These discrepancies highlight areas for potential improvement in the provision of health care to minority women.

Adult↗