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Biomedical subjects

S Pingree

Publications and source records attributed to S Pingree.

16 recordsLinked to original sources
PubMed2001

Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma: a prospective study.

BACKGROUND: Studies that prospectively and simultaneously evaluate, within the first year of diagnosis, the impact of surgery and chemotherapy on quality of life (QOL) of younger women (60 years or younger) with early stage breast carcinoma are limited. METHODS: Quality of life of 103 women who had surgery (lumpectomy, 49; mastectomy, 54) approximately 1 month before the start of the study was evaluated at baseline and again after 5 months. Thirty-two women received chemotherapy during the study. RESULTS: Over time, subjects reported improvement in body image and physical, emotional, and functional well-being (P < 0.001). They were less bothered by swollen/tender arms and worried less about risk of cancer to family members (P < 0.001). However, satisfaction with sex life, social support, and social/family well-being declined (P < 0.001). In the period closer to surgery, women with mastectomy reported poorer body image (P = 0.001) and worse functional (P = 0.08) and physical well-being (P = 0.10). Women with lumpectomy worried more about the effects of stress on their illness (P < 0.01) and had lower emotional well-being (P = 0.06). By 6 months after surgery, the two groups reported similar QOL scores. Chemotherapy had a negative impact on women's sexual functioning (P = 0.01) and their physical well-being (P = 0.09). Women who received chemotherapy also reported more shortness of breath (P = 0.07). Post hoc analysis showed that women with breast reconstruction had higher emotional well-being at baseline than those with lumpectomy (P = 0.001) and mastectomy alone (P < 0.01). CONCLUSIONS: Younger women with breast carcinoma could experience a range of adjustment problems at various points in the treatment cycle. Interventions that would help reduce the negative impact of treatment on QOL need to be designed and integrated into routine clinical practice.

Adaptation, Psychological↗
PubMed2001

Effect of computer support on younger women with breast cancer.

OBJECTIVE: Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved. DESIGN: Randomized controlled trial conducted between 1995 and 1998. SETTING: Five sites: two teaching hospitals (Madison, Wis, and Chicago, Ill), two nonteaching hospitals (Chicago), and a cancer resource center (Indianapolis, Ill). The latter three sites treat many underserved patients. PARTICIPANTS: Newly diagnosed breast cancer patients (N = 246) under age 60. INTERVENTIONS: Experimental group received Comprehensive Health Enhancement Support System (CHESS), a home-based computer system providing information, decision-making, and emotional support. MEASUREMENTS AND MAIN RESULTS: Pretest and two post-test surveys (at two- and five-month follow-up) measured aspects of participation in care, social/information support, and quality of life. At two-month follow-up, the CHESS group was significantly more competent at seeking information, more comfortable participating in care, and had greater confidence in doctor(s). At five-month follow-up, the CHESS group had significantly better social support and also greater information competence. In addition, experimental assignment interacted with several indicators of medical underservice (race, education, and lack of insurance), such that CHESS benefits were greater for the disadvantaged than the advantaged group. CONCLUSIONS: Computer-based patient support systems such as CHESS may benefit patients by providing information and social support, and increasing their participation in health care. These benefits may be largest for currently underserved populations.

Adult↗
PubMed2001

CHESS: ten years of research and development in consumer health informatics for broad populations, including the underserved.

This paper reviews the research and development around a consumer health informatics system CHESS (The Comprehensive Health Enhancement Support System) developed and tested by the Center for Health Systems Research and Analysis at the University of Wisconsin. The review will place particular emphasis on what has been found with regard to the acceptance and use of such systems by high risk and underserved groups.

Aged↗
PubMed1999

Impact of a patient-centered, computer-based health information/support system.

BACKGROUND: Consumer health information systems potentially improve a patient's quality of life and activate patient self-care. OBJECTIVES: Test a computerized system (CHESS: Comprehensive Health Enhancement Support System), which, in this application, provided HIV-positive patients with information, decision support, and connections to experts and other patients. Would patients given in-home access to computers use the system, improve their quality of life, reduce health-risk behaviors, and use medical services more efficiently? RESEARCH DESIGN: Randomized controlled trial: CHESS computers in experimental subjects' homes in Madison or Milwaukee, Wisconsin, for 3 or 6 months; controls received no intervention. Subjects were compensated for self-report surveys completed before, during, and after CHESS installation. SUBJECTS: Of 204 HIV-positive patients recruited (90% male, 84% white, average education some college, and 65% experiencing HIV-related symptoms), 90% completed the study. MEASURES: Self-reports of quality of life and frequency and duration of use of medical services. RESULTS: CHESS was used daily with little difference between demographic subgroups. While CHESS was in the home, its users reported quality-of-life improvements: active life, negative emotions, cognitive function, social support, and participation in health care. They also reported spending less time during ambulatory care visits, making more phone calls to providers, and experiencing fewer and shorter hospitalizations. CONCLUSIONS: A computer-based personal health support system can improve a patient's quality of life and promote more efficient use of health care.

Adult↗
PubMed1995

CHESS (Comprehensive Health Enhancement Support System): an interactive computer system for women with breast cancer piloted with an underserved population.

The Comprehensive Health Enhancement Support System (CHESS) is an interactive computer system containing information, social support, and problem-solving tools. It was developed with intensive input from potential users through needs-assessment surveys and field testing. CHESS had previously been used by women in the middle and upper socioeconomic classes with high school and college education. This article reports on the results of a pilot study involving eight African-American women with breast cancer from impoverished neighborhoods in Chicago. CHESS was very well received; was extensively used; and produced feelings of acceptance, motivation, understanding, and relief.

Ambulatory Care Information Systems↗
PubMed1994

The comprehensive health enhancement support system.

This article describes the process of using needs assessment data to develop an interactive information technology specifically designed to support patients in a health-related crisis. The Comprehensive Health Enhancement Support System (CHESS) is an interactive information, social support, and problem-solving system that was developed by a team at the University of Wisconsin. This article looks at the program developed for breast cancer patients and their families.

Breast Neoplasms↗
PubMed1994

The use and impact of a computer-based support system for people living with AIDS and HIV infection.

CHESS (the Comprehensive Health Enhancement Support System) is an interactive, computer-based system to support people facing AIDS/HIV Infection and other health-related crises or concerns. CHESS provides information, referral to service providers, support in making tough decisions and networking to experts and others facing the same concerns. CHESS is designed to improve access to health and human services for people who would otherwise face psychological, social, economic or geographic barriers to receiving services. CHESS has been evaluated in a random-assignment study with over 200 men and women living with AIDS and HIV infection. When CHESS was placed in subjects' homes for 3-6 months, use of CHESS was extremely heavy, with the average subject using CHESS 138 times for 39 hours. Compared with a control group which did not receive CHESS, subjects who used CHESS reported significantly higher quality of life in several dimensions, including social support and cognitive functioning. Users also reported significant reductions in some types of health care costs, especially inpatient services (hospitalizations). All segments of the study population used and benefited from CHESS, including women, minorities and those subjects with lower levels of education. Thus, CHESS appears to be an effective means of delivering education and support to the diverse populations which are affected by AIDS and HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Will HIV-positive people use an interactive computer system for information and support? A study of CHESS in two communities.

A study of use of an interactive computer system (CHESS--Comprehensive Health Enhancement Support System) by HIV-Positive people was conducted in Madison and Milwaukee during Fall 1992 and Winter 1993. Computers were placed in homes, and use monitored by the computer. Results showed that the system was used heavily by both samples, and that gender (women used it more) age, (younger used it more), living arrangements (those living alone used it more), and need for health care information (those who felt the most need used it more) but not education predicted use of CHESS. The authors argue that heavy CHESS use by a wide variety of HIV-positive people suggests that the computer can overcome "information poor" barriers in health information campaigns.

Adult↗
PubMed1989

Developing a strategy for understanding adolescent nutrition concerns.

Disseminating nutrition information that adolescents will incorporate into their lives has been a difficult challenge for nutrition educators. The communication of such information has often been a "one-way street"; adolescents are given information that educators feel they need to have. Researchers contend that a more effective way to communicate is for adolescents to describe what they need to know in order to relate nutrition messages to their own worlds. A research model based on Brenda Dervin's work with the "sense-making" theory of communication was used to better determine adolescents' perceived nutrition concerns. Adolescents aged 14 to 16 across six states were interviewed to record personal situations they experienced concerning food, nutrition, and/or eating. Situation "movement states" were identified to determine the qualitative ways in which the adolescents perceived themselves as dealing with the situations they described. Data indicate that this theoretical base may be used by nutrition educators to identify adolescents' nutrition needs and to design appropriate education materials.

Adolescent↗
PubMed1989

The sense-making approach for audience assessment of adolescents.

The purpose of the research was to test the methodology used to identify how adolescents approach their nutrition concerns and questions. The methodology was based on Dervin's sense-making theory. Using a time-line interview technique, 305 adolescents 14 to 16 years of age detailed a situation involving their most important nutrition concerns. Other pertinent information was obtained. Cluster analysis was chosen as the appropriate analysis to identify groups of adolescents who responded similarly to the technique. Discriminant analysis was then used to determine which variables maximally separated the groups. Four groups were identified, two of which described action-oriented approaches to dealing with nutrition situations and differed in terms of how much outside help they wanted. The remaining two groups perceived barriers to dealing with situations and also differed in how much help they wanted. A fifth group indicated no nutrition concerns or questions. The results will be used to develop and test the effectiveness of nutrition education when it is focused on the different approaches.

Adolescent↗
PubMedDate not supplied

Experiences of women with breast cancer: exchanging social support over the CHESS computer network.

Using an existential-phenomenological approach, this paper describes how women with breast cancer experience the giving and receiving of social support in a computer-mediated context. Women viewed their experiences with the computer-mediated support group as an additional and unique source of support in facing their illness. Anonymity within the support group fostered equalized participation and allowed women to communicate in ways that would have been more difficult in a face-to-face context. The asynchronous communication was a frustration to some participants, but some indicated that the format allowed for more thoughtful interaction. Motivations for seeking social support appeared to be a dynamic process, with a consistent progression from a position of receiving support to that of giving support. The primary benefits women received from participation in the group were communicating with other people who shared similar problems and helping others, which allowed them to change their focus from a preoccupation with their own sickness to thinking of others. Consistent with past research is the finding that women in this study expressed that social support is a multidimensional phenomenon and that their computer-mediated support group provided abundant emotional support, encouragement, and informational support. Excerpts from the phenomenological interviews are used to review and highlight key theoretical concepts from the research literatures on computer-mediated communication, social support, and the psychosocial needs of women with breast cancer.

Breast Neoplasms↗
PubMedDate not supplied

Interpersonal communication and rape: women acknowledge their assaults.

Previous research has shown that one in four women experiences rape or attempted rape by the time she is in college. Only half of these women name those experiences as sexual assault, an action which is an important part of recovery. This article examines whether a convenience sample of 123 undergraduate women, living in dormitories and sororities at a large midwestern university, who experienced unwanted anal, oral, or vaginal intercourse through threat of force, drugs, or intoxication name those experiences as rape and whether those women who acknowledge their rapes have better psychosocial adjustment. It further examines whether interpersonal communication variables predict rape acknowledgment. Results indicate women who acknowledge their experiences as rape score better on examined psychosocial adjustment variables. Hierarchical regression including demographics, situational variables specific to their own rapes, and interpersonal communication variables about acquaintance rape reveal that interpersonal communication about acquaintance rape, such as gaining information about acquaintance rape from friends and knowing someone who has been acquaintance raped, significantly predict acknowledging rape above and beyond situational and demographic variables. Therefore, sharing common stories is an important way in which these young women name or redefine their experiences as rape. This research also shows there is an important stage in between "yes I was raped" and "no I was not raped" that warrants further investigation to understand the nature of redefining or naming a rape experience as rape.

Adolescent↗
PubMedDate not supplied

The quality of interactive computer use among HIV-infected individuals.

This study examined how HIV-infected individuals used an interactive health software package called CHESS (Comprehensive Health Enhancement Support System). CHESS packages information and support in a variety of ways; the research examined how a subset of users whose posttest scores in a larger randomized trial showed significant improvement in quality of life compared on use patterns of CHESS with those who did not improve. The evidence presented here points to the nature of CHESS use more than it does to the amount of CHESS use. Those whose quality of life improved were among the most involved in their use of CHESS information tools. That is, even though Discussion Group accounted for the majority of all CHESS uses and time spent with the system, total use and Discussion Group use appeared less important than use of the information tools, especially if that use was at least somewhat sustained and involved.

Adult↗