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Biomedical subjects

K L McCance

Publications and source records attributed to K L McCance.

7 recordsLinked to original sources

Preventing coronary heart disease in high-risk families.

A preventive nursing intervention to reduce coronary heart disease (CHD) risk was tested. The sample was 19 families composed of 58 first-degreed relatives of young (age 30-55 years) victims of sudden cardiac death. Families were randomly assigned to control and experimental groups. The intervention at 3-5 months postdeath focused on assessment of health history, health behaviors, health beliefs, informing and educating about CHD risk factors, and methods for detecting and reducing these factors. The control group received mailed questionnaires and no intervention. The subject's reduction of CHD risk was measured at 7 months by changes in high risk CHD behaviors, changes in health beliefs, and adherence to screening for serum cholesterol and blood pressure determination. Analysis of covariance (covarying age and pretest scores) demonstrated no differences between groups for health beliefs; however, significant differences for health beliefs existed between the sibling subgroups. The intervention was correlated with a significant reduction in alcohol intake. Reductions in high fat meat consumption were in the desired direction. Greater percentages of subjects in the intervention group obtained blood pressure and cholesterol screening.

Adult

Coping with relocation.

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Adaptation, Psychological

Results of a national survey of physicians' knowledge and application of prevention capabilities.

We used the Comprehensive Prevention Knowledge and Applications Survey Instrument to study health promotion and disease prevention activities of a national sample of 777 family physicians. The study demonstrated active counseling in some areas, such as smoking cessation, but lesser efforts in other aspects, including counseling about smokeless tobacco cessation, seat belt use, sunlight exposure, prevention of AIDS and other sexually transmitted diseases, and preconceptual counseling. Although respondents thought themselves prepared to counsel about prevention efforts, they reported limited success in changing patients' behavior. The physicians documented frequent application of many prevention techniques, and they noted much more frequent use of mammography than has been reported in prior studies. The survey results indicate the need for modification of medical education programs and for enhancement of ability to change behavior to reduce health risks.

Acquired Immunodeficiency Syndrome

The Comprehensive Prevention Knowledge and Applications Survey Instrument: its validity and reliability.

Because the instruments used to measure current practices among primary care physicians in a broad range of prevention activities are limited, we developed a study to test a tool that would evaluate current prevention knowledge and applications, including items regarding activities to prevent AIDS and other sexually transmitted diseases. The Comprehensive Prevention Knowledge and Applications Survey Instrument measures knowledge, counseling capabilities, and use of recommended applications in preventive medicine. We designed and tested a 74-item instrument. Four recognized experts in preventive medicine and public health determined its content validity. We then proceeded with reliability testing with a random sample of 315 family physicians and replicated it with an additional 432 physicians for stability reliability. Internal consistency reliability and stability reliability have both been demonstrated for this instrument.

Health Knowledge, Attitudes, Practice

A survey of physicians' knowledge and application of AIDS prevention capabilities.

Currently, no effective immunization prevents AIDS and no curative treatment exists for the AIDS patient. However, sufficient knowledge of the pathophysiology of this disease exists to prevent its spread. Effective application of this capability requires that health care providers secure and apply this knowledge. This study reports the results of a national survey of family physicians' knowledge and application of AIDS prevention capabilities. The Comprehensive Prevention Knowledge Applications Survey Instrument was used for the survey. It revealed that, in contrast to other prevention activities, respondents (n = 765) reported low use of practices important in AIDS prevention. For example, only 18% routinely obtain sexual histories from patients seen regularly, and, of those obtaining these histories, fewer than 20% routinely obtain information regarding high-risk activities. Over 40% do not routinely ask about homosexual activities, and almost 60% omit questions about intravenous drug use, even though the patient has symptoms suggesting AIDS in both instances. Methods of enhancing application of available capabilities may focus on expanded education and intervention activities.

Acquired Immunodeficiency Syndrome

Validity and reliability of a breast cancer knowledge test.

A study was made to develop and test a tool to measure a subject's knowledge about breast cancer screening in order to implement effective strategies for prevention and early detection. The Breast Cancer Knowledge Test measures a subject's knowledge about detection and screening practices. The instrument is an expansion of Stillman's Knowledge Questionnaire. A 30-item test was designed and pretested. Four nationally recognized experts in cancer control determined content validity. Reliability testing then was done with a sample of 101 women 50 years of age and older. The complete posttested 18-item instrument is reported here. Correlational analyses were done between the total scores on the Breast Cancer Knowledge test and subjects' practice of screening behaviors. Findings indicate that more knowledge of breast cancer screening is associated with use of mammography and obtaining a professional examination, but not with the practice of breast self-examination.

Aged

Leg volume changes with EPIC and posturing in dependent pregnancy edema.

This study explored the differential effects of external pneumatic intermittent compression (EPIC) and posturing on leg volume changes in healthy pregnant women with dependent leg edema. Thirty-five healthy pregnant women with severe pedal edema were randomly assigned to one of two treatment groups. The experimental group (n = 17) received EPIC for 30 minutes at 40 torr while in the left lateral recumbent position. Control women (n = 18) were similarly positioned, but received no EPIC. Both groups walked for 10 minutes following left lateral posturing. Circumference measures required for leg volume estimates were made: prior to posturing (Time 1), immediately after posturing (Time 2), and following the ambulation period (Time 3). Volume losses for the experimental group were greater than for the control group at Time 2. Although volume losses for the experimental group had reversed somewhat at Time 3, they remained greater than control group losses, which did not change from Time 2 to Time 3. Analysis of covariance revealed significant mean volume losses for both experimental and control groups, with ponderal index the only significant covariate.

Adult