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Biomedical subjects

S P Weinrich

Publications and source records attributed to S P Weinrich.

At least 19 recordsLinked to original sources

Perceived health status in African American and Caucasian men 40 to 70 years old.

There is limited data on the relationship between perceived health status and the demographic variables of education and income in African American men. A sample of 2,001 men (72% African Americans and 28% Caucasians) who were participating in prostate cancer screening was studied to identify predictors of men's health status. Data on the concepts of self-rated health status, age, race, education, income, living arrangements, and marital status were collected. Findings indicated that men who were more likely to report excellent health status were older Caucasians, had more than a high school education, an annual income over 25,021 dollars, were living with others, and were married. Men more likely to report fair health status were older African Americans, unmarried, had less than a high school education, had an annual income less than 9,600 dollars, were living alone, and were unmarried. Implications for targeting at-risk men are presented.

Adult↗

Psychosocial stress and prostate cancer: a theoretical model.

African-American men are more likely to develop and die from prostate cancer than are European-American men; yet, factors responsible for the racial disparity in incidence and mortality have not been elucidated. Socioeconomic disadvantage is more prevalent among African-American than among European-American men. Socioeconomic disadvantage can lead to psychosocial stress and may be linked to negative lifestyle behaviors. Regardless of socioeconomic position, African-American men routinely experience racism-induced stress. We propose a theoretical framework for an association between psychosocial stress and prostate cancer. Within the context of history and culture, we further propose that psychosocial stress may partially explain the variable incidence of prostate cancer between these diverse groups. Psychosocial stress may negatively impact the immune system leaving the individual susceptible to malignancies. Behavioral responses to psychosocial stress are amenable to change. If psychosocial stress is found to negatively impact prostate cancer risk, interventions may be designed to modify reactions to environmental demands.

Black or African American↗

Obstacles to prostate cancer screening in African-American men.

The purpose of this correlational study was to measure structural obstacles to a free prostate cancer screening. The sample consisted of 549 men, 69% who were African-American. The men attended a prostate cancer educational program and were offered free prostate cancer screening at their physician of choice. Structural obstacles that were predictors in screening participation were "making an appointment" (p = 0.02), "planning for an appointment" (p = 0.05), and "reminders of prostate cancer screening" (p = 0.02). The demographic variables of race and marital status were also predictors of screening participation. Implications for health education are given.

Adult↗

Barriers to prostate cancer screening.

The revised prostate cancer screening guidelines of the American Cancer Society recommend that men be informed of the risks associated with prostate cancer screening. However, there are no published studies on men's fear of impotence and its impact on prostate cancer screening. In addition, little is known about barriers to prostate cancer screening when the two main barriers of cost and lack of knowledge are eliminated. This study reports the association between barriers and free prostate cancer screening after a prostate cancer education program. All men were called 1 month after a prostate cancer education program and asked: "What would (or did) make it hard for you to get your prostate checkup done?" A total postbarrier score was created to measure how many barriers each man indicated. The following barriers were significant in predicting participation in prostate cancer screening: "put it off," "doctor hours not convenient," "didn't know kind of doctor," "didn't know where to go," and "refuse to go." Fear of impotence was not a significant barrier. Suggestions for reducing barriers to prostate cancer screening are given.

Adult↗

Urinary symptoms as a predictor for participation in prostate cancer screening among African American men.

BACKGROUND: There are minimal data on the influence of urinary symptoms and participation in prostate cancer screening in African American men. METHODS: This correlational study examined the influence of urinary symptoms on 1) participation in a free prostate cancer screening program and 2) abnormal screening results. The 1,402 African American men in the South Carolina Prostate Cancer Project (SCPCP), mean age of 50 years, completed a survey that included self-reported urinary symptoms, participated in a prostate cancer educational program, and received a free prostate cancer screening consisting of a digital rectal examination (DRE) and prostate-specific antigen (PSA) from their personal physician. RESULTS: One in 5 men reported the presence of urinary symptoms. Over 60% of the 1,402 men participated in the free CaP screening. Among the 852 men who participated in the free prostate cancer screening, 73 (8.6%) had abnormal screening results as classified by abnormal DRE and/or PSA >4.0 ng/ml. Urinary symptoms were significant predictors, both of participation in screening (OR = 1.30, CI = 1.00, 1.70) and of obtaining an abnormal screening result (OR = 1.78, CI = 1.17, 2.72). CONCLUSIONS: Prostate cancer health education needs to include the fact that prostate cancer, in its early stages, has no urinary symptoms.

Adult↗

Reference ranges for serum prostate-specific antigen in black and white men without cancer.

OBJECTIVES: To determine the age- and race-specific prostate-specific antigen (PSA) distributions in healthy men in central South Carolina and to compare these to data from other studies. METHODS: Two thousand ninety-two black men aged 40 to 69 years and white men aged 50 to 69 years from the general population in 11 counties of central South Carolina participated in a prostate cancer educational program. Seventy-two percent of the participants were black-about double the proportion in the general population-and 63% of the men (1319 of 2092) subsequently obtained a PSA determination from their own physician. The distribution of serum PSA was compared with distributions from the Olmsted County study and from the Walter Reed Army Medical Center/Center for Prostate Disease Research study. RESULTS: Older men without cancer had higher PSA levels. Regression analyses yielded an associated increase of about 3.3% per year. Reference ranges for normal PSA in men without cancer (based on their sample 95th percentiles) were zero to 1.9, 3.8, and 5.7 ng/mL in black men aged 40 to 49, 50 to 59, and 60 to 69 years, and zero to 2.7 and 4.9 mg/mL in white men aged 50 to 59 and 60 to 69 years, respectively. CONCLUSIONS: Reference ranges for normal serum PSA levels should take into account the population from which they are derived and to which they will be applied. Reference ranges that are useful in the general population can differ from those that are appropriate in a hospital setting. For the general population in central South Carolina, reference ranges for serum PSA levels are lower than previously published reference ranges, particularly among black men.

Adult↗

Predictors of fecal occult blood screening among older socioeconomically disadvantaged Americans: a replication study.

Socioeconomically disadvantaged elderly are less likely to participate in fecal occult blood testing (FOBT). A quasi-experimental design was used in this operational replication study to determine predictors at baseline of subsequent participation in FOBT. Sixty-five percent of the 211 participants in the replication study participated in FOBT, and 47% of the 171 participants in the original study participated in FOBT. Predictors for FOBT in the replication study were male gender, age of 65-75 years old, ability to go places without assistance, history of having had a digital rectal examination and FOBT. This replication study supports targeting socioeconomically disadvantaged populations for FOBT as well as females, persons 85 years and older, persons who need assistance in travel, and person who have not had FOBT before. The results show that socioeconomically disadvantaged persons will participate in FOBT when effective educational interventions that include adaptation for aging changes are used.

Aged↗

Increasing prostate cancer screening in African American men with peer-educator and client-navigator interventions.

BACKGROUND: Few African American men participate in prostate cancer screening, although they have higher prostate cancer incidence and mortality rates. METHODS: This study documents the benefits of two educational methods; the peer-educator method and the client-navigator method, in increasing their participation. RESULTS: Sixty-one percent of the 1,211 African American men who received an educational program on prostate cancer participated in the free prostate cancer screening. Men who received the peer-educator method intervention, which included a testimony in support of prostate cancer screening given by an African American man, were more likely to participate, p = 0.04, than were men who received a standard educational program. Also, men who received the client-navigator method intervention, which included 1) a phone call aimed at overcoming screening barriers and 2) reminders for screening, were more likely to participate, p = 0.0001. CONCLUSIONS: More African American men will participate in prostate cancer screening following the peer-education and client-navigator interventions.

Black or African American↗

Perceived benefits: a predictor of participation in prostate cancer screening.

Prostate cancer is the most frequently diagnosed major cancer and the second cause of cancer-related deaths among men. With early detection through screening and timely treatment, 9 out of 10 men will survive a minimum of 5 years. However, with late diagnoses, only 3 out of 10 men will have a 5-year minimum survival rate. Guided by a conceptual map, this correlational research examined perceived benefits as a predictor of participation in free prostate cancer screening. Perceived benefits are the personal belief and valuing of screening for early detection of prostate cancer. All subjects received one of four educational interventions: traditional, peer educator, client navigator, or combination. Participation in prostate cancer screening was measured by compliance with the American Cancer Society's Guidelines, which included a digital rectal exam (DRE) and/or a prostate-specific antigen (PSA) blood test. The purposive sample (n = 1,522) of men, ages 40 to 70 years, was recruited from randomly selected churches, barbershops, industries, housing projects, and car dealerships in a southeastern state. Seventy-two percent of the sample was African American. Predictors of participation in free prostate cancer screening were these: perceived benefits, being white, having at least a high school education, being married, and receiving the client navigator or combination educational intervention. The Benefits Scale was significant (p = 0.013, odds ratio (OR) = 1.059) as a predictor for participation in screening when all demographic variables and educational interventions were controlled. Practice implications for nursing are discussed and recommendations for future research are presented.

Adult↗

Predictors of participation in prostate cancer screening at worksites.

Unfortunately, African American men have a higher incidence of and a higher mortality rate for prostate cancer than White men but are less likely to participate in prostate cancer screening. This correlational survey research identifies predictors for participation in a free prostate cancer screening in 179 men, 64% of whom are African American. Each man was invited to see his personal physician for a free prostate cancer screening following a prostate cancer educational program given at his worksite. Forty-seven percent of the African American men went to their personal physician following the educational program and received a digital rectal examination (DRE) and a prostate specific antigen (PSA) screening. In the original cohort of educational program attendees, only 16% of the African Americans had obtained a DRE in the previous 12 months. However, 44% subsequently did participate in free DRE screening. Similarly, only 6% of the African American men had received a PSA screening in the previous 12 months, yet 42% obtained a PSA screening after the educational program, a sevenfold increase. Implications for allocating limited resources for education and screening to the high-risk group of African American men are discussed. This study's model of a prostate cancer educational program at worksites followed by attendees visiting their personal physician for screening could be replicated throughout the United States to increase African American men's participation in prostate cancer screening.

Adult↗

Assessment and management of sleep disorders in the elderly.

Sleep disorders are major syndromes that can interfere with falling to sleep or maintaining sleep, or produce excessive daytime sleepiness. Sleep disorders are rarely diagnosed in the elderly due to age-related changes in sleep patterns. Gerontological nurses can assist the elderly client to achieve improved sleep through increased awareness of sleep disorders, related assessment tools, and interventions.

Aged↗

The impact of prostate cancer knowledge on cancer screening.

PURPOSE/OBJECTIVES: To test the effect of knowledge on participation in prostate cancer screening. DESIGN: Quasi-experimental design; PRECEDE framework. SAMPLE: 319 men, 82% African American. METHODS: Prostate cancer knowledge was measured with a Prostate Cancer Knowledge Questionnaire prior to a community-based educational program. Men were referred to their personal physicians for a free prostate cancer screening. Results were sent to the Prostate Cancer Project. MAIN RESEARCH VARIABLES: Prostate cancer knowledge and participation in free prostate screening with a digital rectal examination and prostate specific antigen. FINDINGS: Prostate cancer knowledge was a predictor in participation in screening (p = 0.05). IMPLICATIONS FOR NURSING PRACTICE: Nurses need to target educational interventions for African American men, who have the highest incidence of and mortality rates for prostate cancer, to significantly reduce mortality rates. This study documented the importance of providing educational programs to increase participation in prostate cancer screening.

Adult↗

Teaching older adults by adapting for aging changes.

Few teaching programs are geared to meet the special learning needs of the elderly. This pilot study used a quasi-experimental pretest-posttest design to measure the effect of the Adaptation for Aging Changes (AAC) Method on fecal occult blood screening (FOBS) at meal sites for the elderly in the South. The AAC Method uses techniques that adjust the presentation to accommodate for normal aging changes and includes a demonstration of the procedure for collection of the stool blood test, memory reminders of the date to return the stool blood test, and written materials adapted to the 5th grade reading level. In addition, actual practice of the FOBS with the use of peanut butter was added to the AAC Method, making it the AAC with Practice Method (AACP) in two sites. The American Cancer Society's colorectal cancer educational slide-tape show served as the basis for all of the methods. Hemoccult II kits were distributed at no cost to the participants. Descriptive statistics, chi 2, and logistic regressions were used to analyze data from 135 Council on Aging meal sites' participants. The average age of the participants was 72 years; the average educational level was 8th grade; over half the sample was African-American; and half of the participants had incomes below the poverty level. Results support a significant increase in participation in FOBS in participants taught by the AACP Method [chi 2 (1, n = 56) = 5.34, p = 0.02; odds ratio = 6.2]. This research provides support for teaching that makes adaptations for aging changes, especially adaptations that include actual practice of the procedure.

Black or African American↗

Using elderly educators to increase colorectal cancer screening.

This article reports on the elderly educator method, a practical and economical intervention that was used for increasing the rate of return of fecal occult blood sampling in colorectal screening among 171 socioeconomically disadvantaged older persons. Two methods that used elderly educators had an overall response rate of more than 60%. Logistic regression shows a statistically significant difference between two methods that used elderly educators and two methods that did not.

Age Factors↗

Education in the elderly. Adapting and evaluating teaching tools.

1. The patient's Bill of Rights documents the rights of patients to be informed of their illness, health, and treatment. 2. The use of appropriate teaching tools can significantly increase learning, especially if the tools are modified to accommodate normal aging changes. 3. An appropriate teaching tool is a critical component to the learning success of the elderly. 4. With aging changes that result in loss of short-term memory, a teaching tool may make the difference between short-term learning and long-term success.

Aged↗

Knowledge of colorectal cancer among older persons.

Cancer screening is a national health priority, especially for colorectal cancer, the second leading cause of death due to cancer in the United States. The researchers measured colorectal cancer knowledge among 211 older Americans. A quasiexperimental pretest-posttest two-by-two factorial design was used to test the effect of knowledge on participation in fecal occult blood screening. The American Cancer Society's colorectal cancer educational slide-tape presentation served as the basis for all of the educational programs. Hemoccult II kits were distributed at no cost to the participants. Descriptive statistics, chi 2, and logistic regressions were used to analyze data. One-half of the participants had incomes below the poverty level. Almost one-half the subjects in the study sample stated that they had not received any information about colorectal cancer within the past year. Caucasians had more knowledge of colorectal cancer than African Americans [F(1, 78) = 7.92, p < 0.01] and persons with higher income had more knowledge than persons with less income [F(2, 76) = 3.01, p = 0.05]. Subjects showed significant increases in colorectal cancer knowledge 6 days after the colorectal cancer education program [t(79) = 2.59, p = 0.01] and this increased knowledge was a predictor of participation in free fecal occult blood screening [chi 2(1, n = 164) = 5.34, p = 0.02].

Aged↗