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Biomedical subjects

S Occhipinti

Publications and source records attributed to S Occhipinti.

17 recordsLinked to original sources

Making decisions about treatment for localized prostate cancer.

OBJECTIVE: To describe the decision-making processes used by men diagnosed with localized prostate cancer who were considering treatment. PATIENTS AND METHODS: Men newly diagnosed with localized prostate cancer from outpatient urology clinics and urologists' private practices were approached before treatment. Their decision-making processes and information-seeking behaviour was assessed; demographic information was also obtained. RESULTS: Of 119 men approached, 108 (90%) were interviewed; 91% reported non-systematic decision processes, with deferral to the doctor, positive and negative recollections of others' cancer experiences, and the pre-existing belief that surgery is a better cancer treatment being most common. For systematic information processing the mean (sd, range) number of items considered was 4.19 (2.28, 0-11), with 57% of men considering four or fewer treatment/medical aspects of prostate cancer. Men most commonly considered cancer stage (59%), urinary incontinence (55%) and impotence (51%) after surgery, and low overall mortality (45%). Uncertainty about probabilities for cure was reported by 43% of men and fear of cancer spread by 37%. Men also described uncertainty about the probabilities of side-effects (27%), decisional uncertainty (25%) and anticipated decisional regret (18%). Overall, 73% of men sought information about prostate cancer from external sources, most commonly the Internet, followed by family and friends. CONCLUSIONS: In general, men did not use information about medical treatments comprehensively or systematically when making treatment decisions, and their processing of medical information was biased by their previous beliefs about cancer and health. These findings have implications for the provision of informational and decisional support to men considering prostate cancer treatment.

Adult↗

Men's attitudes toward prostate cancer and seeking prostate-specific antigen testing.

BACKGROUND: Although the Australian Cancer Society recommends against performing PSA tests to screen for prostate cancer, many Australian men currently undergo such screening. This study investigated attitudinal variables that may predict prostate cancer screening behaviors in this context. METHODS: A questionnaire was administered by mail in a two-phase procedure, first to a sample of 1,461 men (46% response), then to 919 men from the initial sample. Prostate cancer screening behaviors of men > 40 years old were examined. The questionnaire assessed worry about prostate cancer, perceived vulnerability to prostate cancer, belief in the efficacy of PSA testing for detection, having received a PSA test for detection, and the presence of urologic symptoms at the time of testing. RESULTS: Men who had had PSA testing with urologic symptoms at the time of the test were more worried about prostate cancer and perceived themselves as more vulnerable to prostate cancer compared with both asymptomatic tested and untested men. Men who had undergone PSA testing believed the test to be more effective in the detection of prostate cancer than did men who had not. CONCLUSIONS: Urologic symptoms act as a risk cue for men to prostate cancer. Asymptomatic men should be considered separately from symptomatic men in the investigation of psychological variables predictive of seeking screening for prostate cancer. These findings are discussed in terms of both the focus and design of interventions to alter prostate cancer screening behavior and their implications for the clinical management of men with urologic symptoms.

Adult↗

Domains of distress: the experience of breast cancer in Australia.

PURPOSE/OBJECTIVES: To describe difficulties experienced by women after treatment for primary breast cancer. DESIGN: Descriptive and exploratory. SETTING: Queensland, Australia. SAMPLE: 245 women (70% response rate) less than 16 weeks postsurgery for breast cancer completed a survey. The mean age for this sample was 55 years; 71% had undergone mastectomy, and 29% had undergone conservative breast surgery. METHODS: Focus groups were used to generate items for the survey, "Experience of Breast Cancer Questionnaire" (EBCQ). The EBCQ and the psychological subscale of the Rotterdam Symptom Checklist (RSCL) were administered by mail to the sample. MAIN RESEARCH VARIABLES: Psychological distress, fear of recurrence, decisional uncertainty, informational support, self-image and social relationships, sexual morbidity, and physical effects of treatments. FINDINGS: Factor analysis of the EBCQ identified five factors, accounting for 60% of the variance. These included psychological effects, treatment concerns, physical effects, self-image, and chemotherapy effects. Four of the five subscales had reliability coefficients of greater than 0.80. Psychological effects included cognitive and emotional effects. Treatment concerns included decisional uncertainty and poorly perceived informational support. Physical effects reflected the symptom pattern of axillary dissection. Self-image included breast loss and social isolation. CONCLUSIONS: Nurses who assist women in adjusting to breast cancer should consider the effect of fear of recurrence and perceptions of body image on the recovery process. Because participation in treatment decisions may increase the demands on women at diagnosis, informational support appropriate to each woman's needs is essential. How self-esteem can affect self-image and social relationships after breast cancer requires further investigation. IMPLICATIONS FOR NURSING PRACTICE: Understanding the experience of illness from the perspective of the patient assists nurses in validating their nursing practice and provides clinically relevant information to guide intervention. In particular, supportive psychological care should target both emotional and cognitive responses to breast cancer. Informational support is integral to a patient's satisfaction with treatment decisions and is likely to predict adjustment. When assisting women to adjust to self-image changes, nurses may need to target women's perceptions about their body image.

Body Image↗

Reasoning about food and contamination.

This article examines strategies that are used to reason about food and contamination. In Experiment 1, Ss refrained from choosing a substance that had been given a "poison" label when the intent of the labeler was ambiguous or malicious but preferred this substance when a rationale was provided that dispelled the implication that there once might have been contaminants present. Experiment 2 was designed to compare the effects of safety on conditional reasoning in food and food-irrelevant contexts. When the safety issue was relevant to food in the form of contamination, subjects were most likely to use formal logic in reasoning. A similar pattern of responses was found in Experiment 3 on tasks for which subjects' ratings of their experience of contexts were matched for plausibility, experience, and danger. The results are discussed in terms of an adaptive constraint that facilitates rationality in reasoning within the food domain.

Adult↗

[Conservative surgical treatment of early carcinoma of the breast].

The natural history of breast cancer related with cellular cytodinamics, hematogenous and lymphatic spreading and host defence is presented. It is underlined that surgical methods did not improve survival rates specially for radical procedures. Conservative managements (tumorectomy, wedge resection, subcutaneous mastectomy) for stages T1 No M0 are evaluated. Diagnostic methods for stage I neoplasms are reported especially for infraclinic stages. Surgical techniques are reviewed in detail for the treatment of primitive neoplasms and lymphonodes. After a full examination of controlled clinical series indications for conservative treatment are defined as related to diagnosis and management in special regard for female psychic melieu.

Adult↗

[Treatment of pain in the cancer patient].

Consideration is given to the problem of treating pain in the tumour patient with an examination of the methodological basis of the therapeutic approach in the light of the antalgic, pharmacological and instrumental means at present available. Consideration is also given to the need for setting up multidisciplinary structures (on the lines of the American "Pain Clinic"), which can alone ensure the full effectiveness of therapeutic treatment of "intractable" pain.

Humans↗

[Intensive care units in surgery].

The reasons why intensive care units have become essential are examined. The purpose of such units is to modify the organization of hospital assistance according to the concept of progressive treatment in line with the gravity of the disease concerned. Monitoring techniques as a function of the patient's gravity are outlined and the use of electronic processing as a valuable contribution to the surgeon in providing him with a complete and speedy physiological profile of the seriously ill patient is recommended. Finally, the cost of intensive care units is examined and to keep it down careful attention must be paid to the type of pathology admitted to such units. In spite of this by no means negligible factor, institution of such units is still recommended as quickly as possible, their organization being moulded to the situation in question.

Catheterization↗

The supportive care needs of men with prostate cancer (2000).

The diagnosis and subsequent treatment of prostate cancer is followed by a range of significant disease specific and iatrogenic sequelae. However, the supportive care needs of men with prostate cancer are not well described in the literature. The present study assesses the supportive care needs of men with prostate cancer who are members of prostate cancer self-help groups in Queensland, Australia. In all, 206 men aged between 48 and 85 years (mean=68) completed the Supportive Care Needs Survey (SCNS) (62% response). The SCNS is a validated measure assessing perceived need in the domains of psychological needs, health system and information needs, physical and daily living needs, patient care and support, and sexuality. Items assessing need for access to services and resources were also included. One third of the sample reported a moderate to high need for help for multiple items in the sexuality, psychological and health system and information domains. Younger men reported greater need in the sexuality domain; living in major urban centres was predictive of greater psychological need; being closer to the time of diagnosis was related to greater need for help in the physical and daily living domain; having prostate cancer that is not in remission, having received radiation therapy, and lower levels of education were predictive of greater need for help in patient care and support. Of the total sample, 55% of men had used alternative cancer treatments in the past 12 months, with younger and more educated men more likely to use alternative therapies. Interventions in sexuality, psychological concerns and informational support are priorities for men with prostate cancer.

Aged↗

Social skills, expectancies, and drinking in adolescents.

Research in the field of teenage drinking behavior has shown relationships between both social skills and drinking and alcohol expectancies and drinking. The present research investigated the comparative power of both of these sets of variables in predicting teenage drinking behavior, as well as looking at the contribution of more global cognitive structures. It was hypothesised that adolescents with high alcohol involvement would be discriminated from those with low involvement on the basis of social skills, cognitive structures, and alcohol expectancies. Seven hundred thirty-two adolescents participated in the study. Results indicated that adolescent alcohol involvement was associated with social skills deficits, positive alcohol expectancies, and negative cognitive structures concerning parents and teachers. The results revealed that, although the bulk of the variance in drinking behavior was explained by the independent effects of social skills and expectancies, the interaction of the two constructs explained an additional and significant proportion of the variance. Implications for preventive and treatment programs are discussed.

Adolescent↗