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Biomedical subjects

P Chart

Publications and source records attributed to P Chart.

14 recordsLinked to original sources
PubMed2001

Psychosocial issues following a positive result of genetic testing for BRCA1 and BRCA2 mutations: findings from a focus group and a needs-assessment survey.

BACKGROUND: About 5% of cases of breast cancer and 10% of cases of ovarian cancer are due to an inherited predisposition. Since 1994 it has been possible to test some people at high risk for inherited mutations to the BRCA1 and BRCA2 genes. The purpose of our study was to explore how genetic testing had affected people found to have a BRCA mutation and their families, and to determine whether there was interest in a peer-support group. METHODS: All people given positive results of genetic testing for BRCA1 and BRCA2 mutations at either of 2 familial breast cancer clinics were invited to participate in a focus group and complete a questionnaire. Those who did not attend or who received positive results after the focus group were mailed the questionnaire. Information was sought on the effect of testing on cancer risk perception and worry about cancer, communication of test results to family members, attitudes toward surveillance and toward prevention options, satisfaction with clinical services, need for additional support and satisfaction with decision to undergo testing. RESULTS: Eight of the 27 people invited to participate in the focus group attended. Sixteen of the 26 who were mailed the questionnaire completed and returned it. Although cancer risk perception and worry increased after receipt of the test results, the participants did not regret their decision to undergo testing. Confidence in the efficacy of cancer surveillance was high. Prophylactic oophorectomy was much more acceptable than prophylactic mastectomy. Almost all (92% [22/24]) were satisfied with the clinical services they had received; however, all were dissatisfied with the lengthy wait for test results. Nine (38%) of the participants felt they would benefit from a support group. INTERPRETATION: Adequate resources must be made available to clinical programs providing BRCA1 and BRCA2 mutation testing to ensure appropriate pretest counselling and timely availability of results. Organization of support groups for people found to have the gene mutations should be a priority for these programs.

Adult↗
PubMed2001

Breast disease and undergraduate medical education: a randomized trial to assess the effect of a home study module on medical student performance.

BACKGROUND: This study sought to demonstrate the effectiveness of a home study module (HSM) on student performance at a large urban medical school. METHOD: Second-year students were randomized to receive: 1) a HSM in addition to regular teaching of clinical breast examination or, 2) the regular teaching alone. The HSM included adult learning principles, problem-based learning, and practice guidelines. Students completed a pretest, a post-test, and course evaluation. The pre- and post-tests examined students' knowledge and comfort levels. RESULTS: Of 176 students, 136 agreed to participate and 127 completed both pre- and post-tests. Baseline pretest indicated no significant difference between the intervention and control groups. Post-test showed that students receiving the HSM gained significantly more knowledge than had the control group, and their comfort levels shifted nonsignificantly more. Student evaluations indicated perceived value of the HSM. INTERPRETATION: Student performance can be enhanced and comfort levels increased by providing a critical core of knowledge in the form of a HSM. This approach may be applicable to other important subjects.

Breast Diseases↗
PubMed2001

Self-help groups: oncology nurses' perspectives.

During the past decade in North America, the number of self-help groups for cancer patients has grown dramatically. Nurses' knowledge and attitudes about self-help groups could influence their practice behaviours and the information they provide to cancer patients. However, little is known about oncology nurses' views regarding self-help groups. This study used a cross-sectional survey to gather information about knowledge, attitudes, and practice behaviours of Canadian oncology nurses regarding self-help groups. A total of 676 nurses completed the survey (response rate of 61.3%). The respondents had spent, on average, 21.6 years in nursing and 11.6 years in oncology nursing. Results indicated that a large majority of nurses knew about available self-help groups. Approximately one-fifth of the nurses are speaking frequently about self-help groups with patients (20.7%) and are initiating the conversation on a frequent basis (22.0%). Overall, oncology nurses rated self-help groups as helpful with regards to sharing common experiences (79.5%), sharing information (75.6%), bonding (74.0%), and feeling understood (72.0%). The most frequently identified concern regarding the groups was about misinformation being shared (37.9%), negative effects of associating with the very ill (22.1%), and promoting unconventional therapies (21.2%). Implications from the study suggest that oncology nurses would benefit from learning more about the nature of self-help groups and being able to talk with patients about the self-help experience.

Attitude of Health Personnel↗
PubMed2000

Utilization of professional supportive care services by women with breast cancer.

This paper reports on the results of a survey of utilization of professional supportive care services by women with breast cancer, and on patterns of differential service utilization by sub-groups of patients. Study participants were women with invasive breast cancer diagnosed 23-36 months prior to contact about the study, and randomly selected from the Ontario Cancer Registry. From among 1,119 eligible women sent survey questionnaires, 731 returned completed questionnaires (65%). A total of 31% of respondents reported accessing one or more of the following professionals: social worker, psychologist, psychiatrist, dietitian, physiotherapist. Among those who responded to a question about whether they would have liked specific services, 34% reported that there was at least one professional supportive care service they would have liked to use, but were unable to access. Factors shown to be related to greater utilization of services included: younger age, higher household income, employed or student status, private health insurance coverage, and having received chemotherapy. Overall, there was a surprisingly low utilization of professional specialized supportive care services among women with breast cancer. Policy implications include finding strategies to better inform cancer patients about existing services, and ensuring that a core set of services are available to all patients.

Aged↗
PubMed2000

Changing physicians' attitudes toward self-help groups: an educational intervention.

BACKGROUND: Members of self-help groups (SHGs) for support of cancer patients are concerned that physicians are skeptical about these groups and see them as potentially harmful. The purpose of this study was to assess family physicians' attitudes towards self-help groups and see whether these could be changed through an educational intervention. METHODS: A questionnaire assessing attitudes toward SHGs was mailed to 1,422 eligible Ontario family physicians, to which 911 responded (64% response rate). Responders were sent an educational package consisting of an article about self-help groups, a list of local cancer self-help groups, and a follow-up questionnaire. RESULTS: The study was completed by 584/911 family physicians (64%). After being exposed to educational material, the physicians were more positive about the helpfulness of SHGs (p = 0.021), and less concerned about SHGs' being harmful (p = 0.003). They were more positive about the potential for SHGs to provide participants with opportunities for: sharing information (p = 0.004), bonding with other patients (p < 0.001), feeling understood (p = 0.004), sharing common experiences (p = 0.004), providing hope (p < 0.001), sharing laughter (p = 0.001), becoming more assertive (p < 0.001), communicating with health professionals (p = 0.04), dealing with issues related to death and dying (p = 0.005), advocacy (p = 0.01), and overcoming isolation (p = 0.002). They were less concerned with the potential for SHGs to provide misinformation (p = 0.003), the negative effects of associating with the very ill (p = 0.002), dwelling on illness (p = 0.002), or cultivating false hope (p = 0.001). CONCLUSION: Having family physicians complete a questionnaire, followed by educational material specific to their concerns, changed their attitudes toward self-help groups. Further study is needed to see whether behavioral changes resulted.

Attitude of Health Personnel↗
PubMed1999

Family physicians' perspectives on ovarian cancer.

OBJECTIVE: To describe the knowledge, practices and perspectives of Canadian family physicians regarding ovarian cancer. DESIGN: A mailed survey questionnaire was followed by a reminder card, a second mailing of the questionnaire and a final reminder card. SETTING: A national sample of family physicians was drawn randomly from the membership database of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES: Knowledge related to ovarian cancer. Practices related to the screening and detection of ovarian cancer. Attitudes towards screening for ovarian cancer. Perceived role in the care of women at risk of, or diagnosed with, ovarian cancer. Perceived educational needs of physicians. RESULTS: A total of 1079 completed questionnaires were returned, providing a response rate of 56.6%. Although most family physicians were aware of the basic facts about ovarian cancer, there were knowledge limitations related to risk factors, familial ovarian cancer syndromes and symptoms. Practices related to asymptomatic women were found to be mostly in accord with current guidelines and recognized the prevailing lack of evidence for the effectiveness of tests. Areas that were troublesome included the role of screening in high-risk women and knowledge about available tests. Most family physicians indicated that they have an important role to play in the care of women after they have been diagnosed with ovarian cancer. They also expressed a high level of interest in obtaining additional information related to ovarian cancer. CONCLUSIONS: This study clearly shows that there is a need for additional research to assist with the development of evidence-based guidelines for women at increased risk of ovarian cancer and for women at no known risk. Pending more definitive evidence, interim guidelines could provide assistance to physicians currently having to make decisions in a context of massive uncertainty. Canadian family physicians would be interested in and would benefit from continuing medical education (CME) initiatives concerning ovarian cancer.

Adult↗
PubMed1998

A strategy for informing patients and health professionals about unconventional cancer therapies.

BACKGROUND: A Guide to Unconventional Cancer Therapies was produced by the Ontario Breast Cancer Information Exchange Project with the intention of meeting needs of patients, family members, and health professionals for information about unconventional therapies. Concerns raised by health professionals during the development of the guide serve as a focus for considering its impact on cancer patients who purchased it. MATERIALS AND METHODS: Purchasers of the guide were sent a survey questionnaire inquiring about their access to, use of, and attitudes toward it. RESULTS: A total of 634 individuals responded to the survey, including cancer patients, health professionals, and family members. The guide was rated moderately helpful overall, and health professionals found it significantly more helpful than did cancer patients. A minority of patients were influenced to try an unconventional therapy as a result of reading the guide. Those who did try a new therapy typically chose ones that are most popular and have few potential negative effects. CONCLUSIONS: As an informational strategy, the Guide to Unconventional Cancer Therapies has been successful. Concerns expressed by some health professionals about potential harm through implementing the strategy have been shown to be largely unwarranted, at least for study respondents.

Breast Neoplasms↗
PubMed1998

Information needs of nurses regarding breast disease.

The purpose of this study was to identify the information needs of nurses regarding benign breast conditions and breast cancer. One hundred and five Ontario nurses who are directly involved in providing information to women were interviewed. The majority of nurses indicated feeling either somewhat or very comfortable during their discussions with women and perceived their knowledge was sufficient for answering women's questions. Nurses rated existing information concerning discovery of breast abnormalities and the diagnostic phases the highest in terms of quality, quantity and accessibility. Overall, a large proportion of nurses did not perceive gaps in information for nurses about breast disease. This work raises interesting practice questions for nursing in light of the reports by patients that they experience difficulties obtaining information.

Breast Neoplasms↗
PubMed1998

Self-help groups.

OBJECTIVE: To assess Ontario family physicians' attitudes toward, awareness of, and practices related to self-help groups in general and cancer self-help groups specifically. DESIGN: Mailed survey using a modified Dillman method. SETTING: Ontario family practices. PARTICIPANTS: A random sample of 1500 Ontario members of the College of Family Physicians of Canada, of whom 949 responded. A total of 911 completed questionnaires were received, for an eligible response rate of 64%. MAIN OUTCOME MEASURES: Physician demographics, practice characteristics; extent of awareness of self-help groups and their perceived value; attitudes toward self-help groups; practices related to interactions with patients about self-help groups. RESULTS: Only 40.2% of respondents were aware of six or more self-help groups in their region; 56.8% were aware of at least one cancer self-help group. Discussions with patients about groups were reported as occurring "frequently" by 12% of respondents, who indicated they made referrals to an array of groups. Ratings of group helpfulness were relatively high (83.8% scoring 3, 4, or 5 on a 5-point scale, where 5 is "very helpful"). There were low ratings of potential harm (1% scoring 4 or 5 on a 5-point scale, where 5 is "very harmful"). Confidence intervals for proportions reported on in this paper were all within 4%. CONCLUSIONS: Family physicians have predominantly positive attitudes about the potential benefits of self-help groups, and many are recommending groups to their patients.

Female↗
PubMed1997

Physician perspectives on unconventional cancer therapies.

The popularity of unconventional therapies has grown dramatically in recent years. This paper reports on the results of a pilot study investigating the perspectives of physicians involved with cancer care regarding their reactions to this trend and their ways of trying to meet associated challenges. Nine oncologists, nine general practitioners, and one surgeon were interviewed over the telephone, employing open-ended questions. The physicians were unanimously interested in having information available about unconventional therapies. They also expressed a desire to be supportive of patient choices in this area, provided conventional therapy was not compromised. However, there was little interest in initiating communication about unconventional therapies, with most seeing such discussions as a poor use of their time. Suggestions for future research, as well as educational and policy strategies, are addressed.

Attitude of Health Personnel↗
PubMed1983

Inflammation of the lacrimal drainage system--assessment by thermography.

Thermography is an investigative tool without side effects. To our knowledge thermography has not been evaluated in the assessment of lacrimal passage inflammation and obstruction. It can give an objective assessment of presence and degree of inflammation. An infrared scanning device was used to detect surface temperatures in 29 patients with known disorders of the lacrimal drainage passage. Thermal images were compared for bilateral symmetry and against the normal thermographic appearance of the face. Acute dacryocystitis and canaliculitis showed gross hyperthermia and asymmetry. Forty-two percent of patients with a picture of chronic dacryocystitis and 40% of patients with only tearing and no clinical evidence of inflammation showed temperature elevation on the side of involvement, whereas 58% and 60% of these respective groups showed symmetrical thermal patterns, suggesting no active inflammation. In a few cases there were discrepancies between clinical assessment and objective thermographic evaluation of the degree of inflammation. The implications of our results and possible applications of thermography are discussed.

Acute Disease↗
PubMed1982

Thermographic evaluation of the human lacrimal drainage system.

A new method for evaluating the anatomy and patency of the human lacrimal drainage system is presented. Thermography was used in conjunction with routine lacrimal irrigation to visualize the tear ducts in normal subjects and in a patient with obstructive epiphora. The canaliculi, common canal, and lacrimal sac could be identified, and certain abnormalities detected with this technique. Additional information can be obtained regarding the presence of subclinical inflammation. The authors feel that thermography offers promise as a safe, simple technique for evaluating the lacrimal anatomy in patients with epiphora.

Dacryocystitis↗
PubMedDate not supplied

Cancer self-help groups and family physicians.

PURPOSE: Despite the phenomenal growth during the past decade of cancer self-help groups for adult patients with cancer, little research has been conducted to document the interface between these groups and healthcare professionals, especially physicians. This study was initiated to provide information about family physician practices, awareness, and attitudes about self-help groups. DESCRIPTION: A survey questionnaire was mailed to a random sample of Ontario family physicians drawn from the College of Family Physicians of Canada's membership database. RESULTS: A total of 911 completed questionnaires were returned, for a response rate of 64%. A majority (56.8%) of respondents were aware of at least one cancer self-help group in their region; 26.8% of these spoke frequently with their cancer patients about such groups. Most family physicians indicated that they were positively inclined toward cancer self-help groups, giving especially high ratings of helpfulness to sharing common experiences, overcoming isolation, feeling understood, and sharing information. Ratings of potential harm were low, with the most concern expressed about the possible provision of misinformation and the promotion of unconventional therapies. Responses to an open-ended question showed that many family physicians qualify their support for cancer self-help groups, depending on patient need, group composition, and leadership. CLINICAL IMPLICATIONS: Family physicians and other members of the cancer care team should give increased attention to informing cancer patients about the potential benefits of self-help groups. Efforts need to be made to assist cancer self-help groups in developing informational brochures and to ensure that groups are listed in cancer resource directories. Educational initiatives about self-help groups would be useful for family physicians and other health professionals engaged in the care of cancer patients.

Adult↗