Biomedical subjects

P Booher

Publications and source records attributed to P Booher.

5 recordsLinked to original sources

PubMed1991

Breast cancer screening in older women: practices and barriers reported by primary care physicians.

Annual mammography, in combination with clinical breast examinations, can reduce mortality from breast cancer. However, surveys of both patients and physicians suggest that mammography is underutilized. This study examined whether physicians' reported breast cancer screening practices and barriers to mammography varied with patients' age. Data from 576 primary care physicians (internal medicine, family/general practice, and obstetrics/gynecology) who participated in a mailed statewide survey were analyzed. Physicians reported screening elderly women significantly less often than younger women, regardless of family history of breast cancer. With the exception of medical specialty, physicians' demographic and practice characteristics were not associated with reported screening practices. However, physicians' knowledge and beliefs about breast cancer in older women were associated with reported screening practices. When analyzing barriers to ordering mammography, cost to the patient was viewed as a barrier for women of all ages, and pain was viewed as a greater barrier for younger women; otherwise, physicians consistently believed that their elderly patients faced considerably more barriers compared with younger women. Further investigation is required to examine why primary care physicians report age-related differences in both breast screening and barriers to mammography.

Aged↗

PubMed1991

The impact of increased contact on psychosocial outcomes in patients with osteoarthritis: a randomized, controlled trial.

After baseline in home interviews, 439 patients with osteoarthritis (OA) were randomly assigned to the control or one of 3 intervention groups which differed only in method of delivery (i.e., phone, clinic, both). Trained nonclinical interviewers reviewed medications, problems with joint pain, gastrointestinal symptoms, early warning signs for common chronic diseases, scheduled outpatient visits, an evening/weekend clinic telephone number, barriers to care, and suggestions to encourage participation during clinic visits. We hypothesized that the intervention would enhance social support, satisfaction with care, morale, and medication compliance. We found that none of the interventions had any effect upon these outcomes.

Aged↗

PubMed1990

Social support, stress and functional status in patients with osteoarthritis.

We investigated the relationship among social support, stress and functional status in 439 patients with osteoarthritis (OA). OA is among the most prevalent diseases affecting American adults and is a major contributor to functional impairment, morbidity, and utilization of health care resources. This study examines whether the impact of social support upon health was direct or indirect (i.e. it was present only when respondents were exposed to stressors). We also wanted to explore the relationship between functional status and specific dimensions of support (i.e. self-esteem, appraisal, belonging, and tangible support). Functional status (psychological disability, physical disability, pain) was assessed with the Arthritis Impact Measurement Scales (AIMS). Multiple regression suggested that exposure to stressors and low self-esteem support were associated with increased disability along all AIMS dimensions; appraisal support was not correlated with any AIMS score. Also, physical disability was associated with being older and having less tangible support (R2 = 0.17); psychological disability with being younger, caucasian, and having less belonging support (R2 = 0.47); and pain with being younger, caucasian and having less education (R2 = 0.15). In no instance was there empirical support for the buffering model. Self-esteem appeared to be the most, and appraisal the least, consistent social support dimension when predicting functional status. While exposure to stressors negatively affected all AIMS dimensions, its impact was greatest with respect to psychological disability. We conclude that social support had a direct, rather than indirect, impact on functional status. Future research should consider separately the impact of distinct social support dimensions.

Activities of Daily Living↗

PubMed1989

Can the provision of information to patients with osteoarthritis improve functional status? A randomized, controlled trial.

After we assessed the functional status of 439 patients with osteoarthritis, we randomly assigned them to 1 of 3 intervention groups or to a control group. The interventions consisted of providing information, and differed only in the method of delivery: by phone, in person at the clinic, or both. Physical health improved (P = 0.02), pain was reduced (P = 0.02), and psychological health improved marginally (P = 0.10) in patients contacted by phone compared with those not contacted by phone. In those contacted only at the clinic, physical health worsened (P = 0.02), but neither pain (P = 0.80) nor psychological health (P = 0.90) differed from the values in patients not contacted at the clinic. We conclude that telephone contact is a useful intervention that can enhance the functional status of patients with osteoarthritis.

Consumer Behavior↗

PubMed1989

Common problems experienced by adults with osteoarthritis.

Functional status and noncompliance were assessed at baseline in 327 patients with osteoarthritis (OA), 96% of whom were interviewed again later either by telephone or at their next scheduled primary care visit. One-third of the sample reported noncompliance at baseline. During the follow-up interviews, commonly identified problems included having an inadequate supply of medicines to last until their next physician visit (47%), experiencing gastrointestinal complaints (36%), and reporting barriers to primary care (32%). For OA patients with hypertension or heart disease (N = 241), 75% reported clinically important symptoms. Patients with poorer functional status at baseline generally reported more subsequent problems. We conclude that patients frequently have correctable problems (e.g., medication noncompliance and side effects, barriers to care). These patients may be identified prospectively by their poor functional status. Arthritis health care professionals may wish to consider patient-oriented interventions to obviate these problems when evaluating functional status.

Chronic Disease↗