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Biomedical subjects

J R Bloom

Publications and source records attributed to J R Bloom.

51 records · Page 3Linked to original sources
PubMed1979

Team care: solution for hospital oncology units?

Team care promises improved patient care through improved coordination of existing hospital services, as well as continuity of care for the patient between the hospital and the home. Commitment to the team concept, however, calls for more than lip service.

Cancer Care Facilities↗
PubMed1979

The nurse practitioner and hypertension control: a pilot study.

Hypertension is the major health problem affecting blacks today. Socioecological stress is implicated in areas in which excess mortality exists. The nurse practitioner, whose role has been established in providing medical treatment for hypertension, also has a role in alleviating social stressors. The objective in this study was to determine the nurse practitioner's effectiveness in reducing stress and whether stress reduction resulted in blood pressure reduction. The results indicate that the nurse practitioner's intervention was effective--when patients complied with her suggestions both socioecological stress and blood pressure were significantly reduced.

Black or African American↗
PubMed1979

Changing images of professionalism: the case of public health nurses.

A survey of 89 public health nurses in a California county explored factors that might account for the growing support of unions and subsequent militancy among nurses. As predicted, changes in the backgrounds of public health nurses have occurred over time: 1) older nurses are more likely to have graduated from a diploma program and to have parents of lower educational and occupational attainment than younger nurses; 2) older nurses are more likely to view nursing as a calling and less likely to desire representation in collective bargaining by the union or to believe striking professional; 3) older nurses and those from lower social class backgrounds were less likely to belong to the union and less likely to participate in a county-wide strike. Because age and parental background factors are independently related to our indicators of militancy--union membership and participation in a strike--the results are interpreted as a change in nurses' images of professionalism.

Adult↗
PubMedDate not supplied

Intrusiveness of illness and quality of life in young women with breast cancer.

Our objective was to test a theoretical model that explains quality of life as a function of the intrusiveness of illness encroaching on the different domains of one's life. The intrusiveness of illness is explained not only by disease and treatment related factors, but also by one's psychological and social resources (Devins, 1994). To investigate this issue, a sample of 336 women aged 50 and under, recently diagnosed with breast cancer were interviewed in their homes. Consistent with Devins' model, intrusiveness of illness mediated the effect of disease and treatment factors on quality of life. Contrary to his model, some treatment factors also had direct effects while social and psychological factors had only direct effects on quality of life. Neither time post-diagnosis nor type of treatment affected the psychological component of quality of life.

Adaptation, Psychological↗
PubMedDate not supplied

The impact of mastectomy on self-concept and social function: a combined cross-sectional and longitudinal study with comparison groups.

Self-concept and social function following radical, modified radical or simple mastectomy for Stage I or II breast cancer, breast biopsy for benign breast disease, cholecystectomy or no operative procedure were measured across a fifteen-month period in a cross-sectional design and across a twelve-month period in a repeated measures design. Women selected for study were without other preexisting mental or physical illness. The degree of disability observed following mastectomy was considerably less than previously reported in uncontrolled studies, with the incidence of actual disturbance extremely small. Women receiving adjuvant therapies following mastectomy, but not women treated by mastectomy alone, reported significantly more body-image dissatisfaction and feminine self-image concerns than the comparison groups. The findings refute previously published impressions of severe psychosocial maladjustments following mastectomy. The study suggests that post-mastectomy women vulnerable to poorer outcome would be those with lower expectations of good quality social support, other present life stressors, other pre-existing chronic diseases, and a disposition to believe in life outcomes as less under their own control.

Adult↗
PubMedDate not supplied

Psychosocial adjustment to breast cancer: a review of selected literature.

The following is a review of the clinical and research literature concerning women's emotional adjustment to the detection of breast cancer and its subsequent management. The review is organized into ten themes which focus on three general areas: 1) women's response to the diagnosis of breast cancer; 2) involvement of spouse, family and professional providers; and 3) the patient's milieu--how it impinges on the course of her treatment and rehabilitation. Also noted is the paucity of systematic research dealing with the effectiveness of support interventions, their content and duration, and the appropriate individual to provide such support.

Adaptation, Psychological↗
PubMedDate not supplied

Factors affecting the use of screening mammography among African American women.

Our objective was to determine the influence of health consciousness in the utilization of mammography in asymptomatic African American women. The sample consisted of 670 women who participated in a household interview in two cities. Logistic regression was used to determine the independent effects of health consciousness, holding constant other factors believed to be related to mammography utilization. Health insurance, income below the poverty line, and an annual physical were not significant predictors. The single most important predictor of having a mammogram was the regular practice of breast self-examination; the group of women who practiced self-examination was almost twice as likely to have a mammogram.

Adult↗
PubMedDate not supplied

Hypertension control through the design of targeted delivery models.

If we discard some of the assumptions upon which curatively oriented medical care is based, we can design models to deliver more effective services for those with chronic diseases. Assumptions to be discarded are--that disease processes can be cured through the delivery of a "magic bullet" rather than controlled through continuous surveillance, -that the physician must be an active decision maker and thus act as gatekeeper and monitor for all disease victims, and -that care for a family of consumers must be provided together. Models for the delivery of services can then be designed to provide continuity of care for those with a specific chronic disease, and paraprofessionals can be used as gatekeepers and monitors, in combination with physicians, rather than physicians alone, to give services. Models can be targeted to reach specific high-risk groups within the population at the workplace, the school, unemployment office, or wherever groups routinely congregate for purposes other than health care. Building targeted models requires extensive knowledge of the specific geographic area and its population as well as knowledge of the natural history of the disease and its treatment. For hypertension programs, goals can be set in terms of numbers of persons whose disease is controlled and the number of new programs initiated as the result of the control efforts.

Comprehensive Health Care↗
PubMedDate not supplied

Evaluation of an extended degree program in public health for working professionals.

The faculty of the School of Public Health, University of California at Berkeley, developed an extended degree program in health services administration for persons who could not attend the university full time. Course formats were redesigned so the courses could be taught off campus in Sacramento and in the San Francisco Bay Area. The extended degree program was designed to be the equivalent of the in-residence program in all respects: the minimum number of units required for the degree was the same and regular faculty taught in both programs. The course of study for the two programs was similar; a major difference, however, was that many more electives were available to on-campus students. Two cohorts of extended degree students were admitted (34 and 37), and 61 completed the program. This article evaluates the success of that program. Evaluation began in 1980, 4 years after the first cohort, and 2 years after the second cohort were graduated--sufficient time for the graduates and faculty to reflect on their experiences. By the measures used--entering grade point average, graduating grade point average, and scores on a common comprehensive examination--the two groups were comparable. Faculty and students alike evaluated the program favorably. All but one graduate stated that they would recommend this program to others if it were available.

Adult↗