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Biomedical subjects

Neeraj K Arora

Publications and source records attributed to Neeraj K Arora.

10 recordsLinked to original sources
PubMed2007

Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer.

We evaluated the helpfulness of informational, emotional, and decision-making support received by women newly diagnosed with breast cancer from their family, friends, and health care providers. Data were collected at two time points via patient surveys: baseline on an average 2 months post-diagnosis and follow-up at 5 months post-baseline. In the period closer to diagnosis, majority of the women received helpful informational support from health care providers (84.0%); helpful emotional support from family (85%), friends (80.4%), and providers (67.1%); and helpful decision-making support from providers (75.2%) and family (71.0%). Emotional support at baseline and emotional and informational support at 5-month follow-up were significantly associated with patients' health-related quality of life and self-efficacy outcomes (p<0.01). Perceived helpfulness of informational, emotional, and decision-making support provided by family, friends, and providers however significantly decreased over time (p<0.001). Cancer patients' desire significant amount of support throughout their cancer journey. Our results show that while patients receive a lot of support during the period closer to diagnosis, receipt of helpful support drops significantly within the first year itself. In order to facilitate cancer patients' adjustment to their illness, efforts need to be made to understand and address their support needs throughout the cancer experience.

Adaptation, Psychological↗
PubMed2006

Understanding cancer patients' experience and outcomes: development and pilot study of the Cancer Care Outcomes Research and Surveillance patient survey.

GOALS OF WORK: The National Cancer Institute's Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium is conducting a population-based study of newly diagnosed patients with lung and colorectal cancer to describe the experience of persons living with cancer and to understand which barriers present the most significant obstacles to their receipt of appropriate care. The keystone to this effort is the baseline patient survey administered approximately 4 months after diagnosis. PATIENTS AND METHODS: We developed a survey to obtain information from patients newly diagnosed with lung and colorectal cancer about their personal characteristics, decision making, experience of care, and outcomes. We conducted a pilot study to evaluate the feasibility of a lengthy and clinically detailed interview in a convenience sample of patients within 8 months of diagnosis (n=71). MAIN RESULTS: The median length of the interviews was 75 min for patients with lung cancer (range 43-130) and 82 min for patients with colorectal cancer (range 46-119). Most patients had received some form of treatment for their cancer: 66.1% had undergone surgery, 28.2% had received radiation therapy, and 54.9% were treated with chemotherapy. In addition, 26.7% reported their overall health was less than 70 on a 0-100 scale, demonstrating that patients with substantial health impairment were able to complete the survey. CONCLUSIONS: A clinically detailed survey of newly diagnosed lung and colorectal cancer patients is feasible. A modified version of this survey is being fielded by the CanCORS Consortium and should provide much needed population-based data regarding patients' experiences across the continuum of cancer care and their outcomes.

Aged↗
PubMed2005

Information needs and sources of information among cancer patients: a systematic review of research (1980-2003).

Understanding what cancer patients need to know and from whom they receive information during the course of care is essential to ensuring quality care. We reviewed 112 articles published from 1980 to 2003 and developed a typology summarizing cancer patients' information needs and the sources from which they receive information. The majority of articles focused on information needs and sources during the diagnosis and treatment phase. Thus, the most frequent information need was treatment-related (38.1%). The most frequent information source was health professionals (27.3%). We examined patients' information needs and sources along the continuum of care and found that during diagnosis and treatment, information needs about the stage of disease, treatment options, and side-effects of treatment were prominent; during post-treatment, patients continued to need information about treatment, and information about recovery was also important. Future research should examine cancer patients' information needs and sources throughout their cancer journey.

Adaptation, Psychological↗
PubMed2005

Examining the relationship of patients' attitudes and beliefs with their self-reported level of participation in medical decision-making.

OBJECTIVE: We applied constructs from the transtheoretical model (TTM) of behavior change to identify modifiable determinants of patient participation in medical decision-making. METHOD: We surveyed a convenience sample of 621 primary care patients at one Boston hospital (response rate 60.6%). With a random half of the sample, we examined the factor structure of a new Patient Attitudes and Beliefs Scale (PABS) that focused on issues about participation in medical decision-making, and with the other half we confirmed the factor structure and examined the association of patients' stage of readiness to participate in decision-making with subscales of the PABS (pros, cons, and decisional balance), self-efficacy, and trust in physician. RESULTS: Patients were classified into 4 stages: precontemplation (don't participate and don't intend to, 17.2%), contemplation (don't participate but contemplating participating, 6.9%), preparation (participate to some degree, 36.1%), and action (participate fully, 39.8%). Factor analysis of the PABS items indicated 2 factors representing pros and cons of participation. Scores on the pros increased and cons decreased significantly from precontemplation to action (P < 0.001). Significant nonlinear associations of stage of readiness with self-efficacy (P < 0.01) and trust in physician (P < 0.01) were evident; self-efficacy scores were highest for those in action whereas trust scores were highest for those in precontemplation. CONCLUSIONS: To move people from precontemplation towards action in participating in medical decision-making, interventions focusing on increasing the pros and decreasing the cons of participation may be needed. The challenge is to balance advocacy for an active patient role with individual patients' preference for participation.

Adult↗
PubMed2003

Interacting with cancer patients: the significance of physicians' communication behavior.

A diagnosis of cancer typically results in patients experiencing uncertainty about and loss of control over their situation, which in turn has a negative influence on their health outcomes. Cancer treatment further disrupts patients' quality of life. Throughout their cancer journey patients often rely on their physicians to provide them with social/interpersonal, informational, and decisional support. A growing body of research shows that physicians' communication behavior does indeed have a positive impact on patient health outcomes. Thus, the patient-physician interaction assumes great significance in the cancer care delivery process. It is encouraging to note that research in this area, largely dominated by studies conducted in primary care, is attracting the attention of cancer researchers. In an attempt to encourage and aid future research on patient-physician communication in cancer care, this paper presents a critical evaluation of existing literature on key elements of physicians' communication behavior (i.e., interpersonal communication, information exchange, and facilitation of patient involvement in decision-making). Different approaches to assessing physician behavior are discussed followed by a review of key findings linking physician behavior with cancer patient health outcomes. Finally, potential limitations of existing research are highlighted and areas for future research are identified.

Communication↗
PubMed2003

Consumer/provider communication research: directions for development.

Communication between health care providers and consumers is a critical part of effective health care delivery. Yet, the strategic use of interpersonal communication in health care delivery is most complex, multifaceted, and often problematic, necessitating careful study of the communication process in health care to increase understanding and help improve health communication practices. The National Cancer Institute (NCI) sponsored an expert symposium on consumer/provider communication research to examine progress and identify gaps in the research literature on doctor/patient communication. This paper and this special issue of Patient Education and Counseling reviews several of the key perspectives and suggestions presented at the symposium for directing future research and applications concerning consumer/provider communication.

Communication↗
PubMed2002

Barriers to information access, perceived health competence, and psychosocial health outcomes: test of a mediation model in a breast cancer sample.

This study examined the relationship between breast cancer patients' experience of barriers to accessing health information and their psychosocial health outcomes and explored the extent to which this relationship was mediated by patient perceptions of competence in dealing with health-related issues. Study sample consisted of 225 women surveyed within 6 months of diagnosis. Regression analyses suggested that patients who reported greater difficulty in accessing needed information experienced lower emotional (P=0.05), functional (P<0.05), and social/family (P<0.05) well-being as well as lower perceptions of health competence (P<0.001). Also, patient perceptions of health competence mediated the relationship between barriers to accessing information and patient outcomes (emotional well-being, P<0.05; functional well-being. P<0.01; social/family well-being, P=0.01). Breast cancer patients often report dissatisfaction with the extent to which their information needs are addressed by their health care providers. Our findings underscore the need for designing and implementing interventions that would aid providers in better meeting the information needs of their patients.

Access to Information↗
PubMedDate not supplied

Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey.

BACKGROUND: The context in which patients consume health information has changed dramatically with diffusion of the Internet, advances in telemedicine, and changes in media health coverage. The objective of this study was to provide nationally representative estimates for health-related uses of the Internet, level of trust in health information sources, and preferences for cancer information sources. METHODS: Data from the Health Information National Trends Survey were used. A total of 6369 persons 18 years or older were studied. The main outcome measures were online health activities, levels of trust, and source preference. RESULTS: Analyses indicated that 63.0% (95% confidence interval [CI], 61.7%-64.3%) of the US adult population in 2003 reported ever going online, with 63.7% (95% CI, 61.7%-65.8%) of the online population having looked for health information for themselves or others at least once in the previous 12 months. Despite newly available communication channels, physicians remained the most highly trusted information source to patients, with 62.4% (95% CI, 60.8%-64.0%) of adults expressing a lot of trust in their physicians. When asked where they preferred going for specific health information, 49.5% (95% CI, 48.1%-50.8%) reported wanting to go to their physicians first. When asked where they actually went, 48.6% (95% CI, 46.1%-51.0%) reported going online first, with only 10.9% (95% CI, 9.5%-12.3%) going to their physicians first. CONCLUSION: The Health Information National Trends Survey data portray a tectonic shift in the ways in which patients consume health and medical information, with more patients looking for information online before talking with their physicians.

Adolescent↗
PubMedDate not supplied

The Health Information National Trends Survey (HINTS): development, design, and dissemination.

Little is known about access, sources, and trust of cancer-related information, or factors that facilitate or hinder communication on a population-wide basis. Through a careful developmental process involving extensive input from many individuals and organizations, the National Cancer Institute (NCI) developed the Health Information National Trends Survey (HINTS) to help fill this gap. This nationally representative telephone survey of 6,369 persons aged > or = 18 years among the general population was first conducted in 2002-2003, and will be repeated biennially depending on availability of funding. The purpose of creating a population survey to be repeated on a cyclical basis is to track trends in the public's rapidly changing use of new communication technologies while charting progress in meeting health communication goals in terms of the public's knowledge, attitudes, and behaviors. The HINTS survey instrument was built upon extant models of health communication and behavior change, taking into account the rapidly changing communication environment. Questions in the survey were drawn from an overall theoretical framework that juxtaposed the"push" aspects of traditional broadcast media against the"pull" aspects of new media. HINTS data will be made widely available for researchers and practitioners; it will help further research in health communication and health promotion and provide useful information for programs, policies, and practices in a variety of settings.

Access to Information↗