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Results for “Secondary Data Analysis”

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PubMed2004

Hispanic ethnicity, language, and depression: physician-patient communication and patient use of alternative treatments.

OBJECTIVE: To examine the relationship between Hispanic ethnicity and language spoken with physician communication about depression and patient use of alternative treatments for depression. METHOD: This is a secondary data analysis from a trial of depression screening conducted in four primary care clinics. Patients with Hispanic or non-Hispanic White ethnic backgrounds and those meeting DSM-III-R criteria for current major depression, minor depression, dysthymia as well as those that screened positive on a depression screening instrument (n = 141) are included in this analysis. We labeled those who screened positive for depression but did not meet DSM-IIIR criteria for a current depressive disorder as "distressed." Clinicians' use of counseling and patient use of alternative treatments were based on patient self-report. RESULTS: Forty-two percent (n = 59) of the sample stated that their physician had either told them that they had depression, treated them for depression, or recommended that they seek help for depression. Over 40% of patients spent time talking with their physicians at their current visit about what was making them depressed and 34% received counseling about depression. Hispanic ethnicity and language were not significantly related to physician communication with patients about how to overcome depression. Thirty-six percent of patients reported talking with a minister or other religious person about feelings of depression or sadness. Seventeen percent of patients had used herbal remedies or non-prescription medications and 5% had seen a curandero for feelings of depression or sadness. Hispanic ethnicity and language were not significantly related to patient use of alternative treatments for depression. CONCLUSIONS: Hispanic ethnicity and language were not significantly related to physician-patient communication about depression or patient use of alternative treatments for depression. Physicians should make sure to ask patients about all of the types of things they are doing to help overcome their depression.

Choice Behavior↗

PubMed1987

Health technology assessment: problems and challenges.

From a national perspective, the central prerequisite of the proper application of medical technology is the timely determination of efficacy, cost, safety, and societal impact. This applies to both the introduction of the new methods and the retirement of older methods that may have outlived their usefulness. Within that framework, the rapid diffusion of innovative methods of great value must be balanced against the cost of premature enthusiasm for techniques with little or no incremental diagnostic or therapeutic gain. A nongovernmental Council on Health Care Technology Assessment of the Institute of Medicine-National Academy of Sciences was established by the Congress in 1986. The Council was charged to serve as an information clearing-house, a center to promote research and education, and a stimulus to establish better methods of assessment and more prompt identification of potentially important technologies. It represents virtually all of the constituencies concerned with adequate evaluation of new and existing methods. The Council confronts the critical problems of timing, bias, the quality of primary data collection, new methods of secondary data analysis, the nature of the "laboratory" in which technology assessment is best accomplished, the "exploitative" character of technology assessment research, appropriate diffusion, and ethnical issues. The appropriate use of technology in modern health care depends on the resolution of these issues.

Organizations↗

PubMed2006

Self-rated emotional health in adults with and without HIV.

Affect is an important indicator of quality of life; unfortunately, many people with Human Immunodeficiency Virus (HIV) disease are vulnerable to depression and negative affect. In a secondary data analysis, 50 HIV-positive and 50 HIV-negative adults between 30 and 65 years old completed several affective measures and rated their emotional health. The HIV-positive adults reported more negative affect than the HIV-negative adults. Older age, loneliness, and HIV stigma were associated with such negative affect.

Adult↗

PubMed2006

Relationship between duration of HIV disease and diagnostic history.

The duration of being infected with HIV, i.e., chronicity, is a unique factor that can affect coping and psychological outcomes. In a secondary data analysis, 50 HIV-positive adults between 30 and 57 years were administered the Centers for Epidemiological Studies-Depression scale, the UCLA Loneliness Scale-Revised, and the HIV Stigma Scale, along with questions about their diagnostic history. Analysis indicated that those diagnosed longer with HIV reported ruminating less on the events leading up to their diagnosis (r=-.36), reported less trauma by their diagnosis initially (r=-.31), and reported fewer depressive symptoms (r=-.30). Implications for addressing chronicity in research are posited.

Adaptation, Psychological↗

PubMed2004

Good days and bad days: the experiences of children of a parent with a psychiatric disability.

Twenty-two children, ages 5 to 17, described their experiences living within a family that included a parent with a psychiatric disability who was involved in community mental health agency services. The children's descriptions of parents' "good days" and "bad days" were captured in a secondary data analysis of a study that included face-to-face children's interviews. Children also discussed their perceptions of psychiatric disabilities and rehabilitation. Children reported more attention from parents on "good days." They expressed concerns about multiple family stressors and bias associated with psychiatric disability. They had little information about psychiatric disabilities and/or rehabilitation. Children recommended "Get help earlier."

Adolescent↗

PubMedDate not supplied

Operationalizing Maslow's theory: development and testing of the basic need satisfaction inventory.

Although Maslow's theory is frequently cited in the nursing literature and is commonly used as an underlying framework for clinical practice, it has been subjected to limited empirical scrutiny. This may be due, in part, to a scarcity of survey measures to operationalize the construct of need satisfaction. The Basic Need Satisfaction Inventory (BNSI) was developed for this purpose. The instrument, created from Andrews and Withey's indicators of life concerns and their "delighted-terrible" scale, was first examined through secondary data analysis, pilot tested (N = 21), and then administered to samples of men and women with chronic pulmonary disease (N = 109) and healthy older adults (N = 100). Emerging evidence of internal consistency reliability and construct validity suggests that the BNSI may be a useful instrument to measure need satisfaction and to test the adequacy of Maslow's theory for nursing science and practice.

Aged↗

PubMed2004

The preliminary assessment of the Social Transition in the North dataset: a comparison of STN survey and enumeration data for selected Northwest Alaskan communities.

OBJECTIVE: This study compared the results from STN survey data with a mailback health study of the same communities to assess the reliability of the STN data. STUDY DESIGN. Sample characteristics and respondes to health questions were compared through secondary data analysis. Data from the STN sample was compared to an enumeration study for the same or similar questions, including demographic characteristics and health status indicators, were compared. METHODS: The STN study used the sample of 715 households in 18 Alaskan and Russian Far East communities to obtain data on the demographic transition, epidemiological transition and domestic transition of residents in northern communities. A study of the health and human service needs was conducted in Northwest Alaska using a mailback health questionnaire within a few years of the STN study. RESULTS: Both data sets appear to be taken from similar populations. Responses to health questions show marked similarities. CONCLUSION: The comparison strongly suggests that the STN data is representative of northern Alaska communities surveyed and can be a valuable source of reliable data on the health and welfare of northern communities. The data on the self-reported prevalence of health conditions may not be useful at the community level.

Alaska↗

PubMed2006

Traditional and market food access in Arctic Canada is affected by economic factors.

OBJECTIVES: This study aimed to evaluate the access that Indigenous women have to traditional and market foods in 44 communities across Arctic Canada. STUDY DESIGN: This secondary data analysis used a cross-sectional survey of 1771 Yukon First Nations, Dene/Métis and Inuit women stratified by age. METHODS: Socio-cultural questionnaires were used to investigate food access and chi-square testing was used to ascertain the distribution of subject responses by age and region. RESULTS: There was considerable regional variation in the ability to afford adequate food, with between 40% and 70% saying they could afford enough food. Similarly, regional variation was reflected in the percentage of the population who could afford, or had access to, hunting or fishing equipment. Up to 50% of the responses indicated inadequate access to fishing and hunting equipment, and up to 46% of participants said they could not afford to go hunting or fishing. CONCLUSIONS: Affordability of market food and accessibility to hunting and fishing in Arctic Canada were major barriers to Indigenous women's food security.

Adult↗

PubMed2003

Are abused women mentally ill?

A secondary data analysis study was conducted on Derogatis Brief Symptom Inventory (BSI) data derived from a larger intervention study of community-based abused women (N = 50). The purpose was to improve understanding of the effect domestic violence has on mental health, given the symptomatology observed in this population. A psychological distress symptom profile was developed and compared with BSI normative data. Findings were unexpected and suggest the necessity to re-examine the assumptions harbored about interpersonal violence in research and practice.

Adult↗

PubMed2003

Co-use of donepezil and hypnotics among Alzheimer's disease patients living in the community.

BACKGROUND: In clinical trials, sleep problems have been identified as side effects of donepezil, an acetylcholinesterase (AChE)-inhibiting medication for the treatment of Alzheimer's disease (AD). Poor sleep quality can exacerbate behavior problems among patients and add to the burden experienced by their caregivers. We examined the relationship between co-use of donepezil and hypnotics in a large sample of persons with AD living in the community. METHOD: This secondary data analysis used cross-sectional subjects from a multiwave, consumer-based survey of AD caregivers conducted in 1997 and 1998. Rates of hypnotic use among users and non-users of donepezil were compared using chi-square analysis for independent samples, and multivariate logistic regression was used to identify significant independent correlates of hypnotic use. RESULTS: A total of 2638 caregivers completed at least 1 study wave. Use of hypnotics was higher in the donepezil subgroup (9.78%) compared with subjects not taking this medication (3.93%). Multivariate analysis demonstrated that donepezil use was independently linked to increased hypnotic use after controlling for the potential confounding effects of disruptive behavior and depressive symptoms (adjusted odds ratio = 3.34, p <.001). CONCLUSION: In this large community sample, donepezil use was statistically linked to increased hypnotic use. Because sleep quality may be a critical issue for persons with AD and their caregivers, more rigorous evaluation of sleep problems linked to AChE-inhibitor treatment is indicated.

Aged↗

PubMedDate not supplied

Effect of health lifestyle pattern on dietary change.

PURPOSE: To examine the effect of lifestyle on the effectiveness of a low-intensity dietary intervention. DESIGN: A secondary data analysis was performed using data from the Eating Patterns Study, a randomized controlled trial that found that self-help materials with physician advice was effective in changing dietary intake and behavior. SETTING: Primary care clinics in a large health maintenance organization. SUBJECTS: A total of 2111 patients with a routine scheduled appointment with their primary care physicians. MEASURES: Participants were grouped into one of six health lifestyle patterns based on similarities in baseline measures of alcohol intake, smoking, diet quality, and exercise. Within each lifestyle pattern, changes from baseline in usual fat and fiber intake (based on a food frequency) and a fat and fiber behavior score were compared at 3 months and 12 months for intervention vs. control participants. INTERVENTION: Self-help materials delivered by a physician with advice to change diet. RESULTS: Intervention participants in the fitness lifestyle group made the largest changes relative to controls for each dietary outcome at 3 and 12 months. For intervention participants defined by their alcohol intake or current smoking, either no changes in diet were observed compared with controls, or early changes were not sustained over time. Intervention-control comparisons within the remaining lifestyle patterns showed smaller dietary changes compared with the fitness lifestyle. This finding was similar to previously published results. CONCLUSIONS: This randomized controlled trial had limited power to detect subgroup differences; however, these results suggest that lifestyle patterns may be useful in the development of effective, targeted interventions to change behavior.

Data Collection↗

PubMed2002

Management of tracheo-bronchial foreign bodies in children.

OBJECTIVES: To review alternative surgical and anaesthetic options in the management of foreign bodies lodged in the tracheobronchial tree in children aged below 10 years. DESIGN: A five year retrospective secondary data analysis. SETTING: Three hospitals based in Eldoret Municipality, Kenya. MAIN OUTCOME MEASURES: Outcome variables included morbidity and mortality. RESULTS: Of the thirty two children studied, 74.1% had bronchoscopy and 25.9% thoracotomy. The overall mortality rate was 3.3%. CONCLUSION: Foreign bodies in the tracheo-bronchial tree are a major cause of morbidity and mortality in children aged below 10 years. In settings where appropriate equipment is inadequate, timely thoracotomy may be life saving.

Age Distribution↗

PubMed2003

Is there a relationship between service integration and differentiation and patient outcomes?

OBJECTIVE: To examine the level of service integration within Maryland hospitals and service differentiation across the hospital system or network and its affect on heart failure patient clinical and economic outcomes. DATA SOURCES/STUDY SETTING: Maryland Health Services Cost Review Commission Inpatient Data for 1997 and 1998 were used for secondary data analysis. STUDY DESIGN: Retrospective cross sectional. Independent variables were the level of service integration and differentiation created from the 1998 American Hospital Association Annual Survey based on the work of Bazzoli et al. The primary dependent variables were readmission, in-hospital mortality, length of stay and costs. DATA COLLECTION/EXTRACTION METHODS: Patients discharged from Maryland hospitals with a diagnosis that grouped to DRG 127 (heart failure) were extracted. Multivariate linear and logistic models clustered by hospital were used to analyse results at the patient level. PRINCIPAL FINDINGS: A higher likelihood of readmission was found as the level of Community Differentiation increased. Although costs were higher as Total Differentiation increased in 1998, these results were not validated by 1997 data. No significant relationship was found between integration of services and outcomes. CONCLUSIONS: Similar outcomes were achieved regardless of the level of service integration or differentiation. Community hospitals produce similar patient outcomes at the same cost for this diagnosis.

Journal Article↗

PubMed1999

End-stage renal disease in aboriginals in New South Wales: a very different picture to the Northern Territory.

OBJECTIVES: To compare the incidence of end-stage renal disease (ESRD) among Aboriginals in New South Wales with the incidence among Aboriginals in the Northern Territory, and to compare the patterns of ESRD among Aboriginals and non-Aboriginals in NSW. DESIGN: Secondary data analysis of information from unpublished and published Australia and New Zealand Dialysis and Transplant Registry reports. MAIN OUTCOME MEASURES: Average annual incidence of ESRD (persons per million); form of renal replacement therapy; mortality at 31 March 1998; patient and graft survival one and five years after transplant. RESULTS: Each year in NSW, 5-17 new Aboriginal patients are treated for ESRD. There was no increase in the average annual incidence of ESRD among NSW Aboriginals (118 per million in 1988-1989 and 111 per million in 1996-1997), whereas incidence in the NT increased from 255 per million to 800 per million. In NSW, ESRD was attributed to diabetes in 32% of Aboriginal patients, compared with 13% of non-Aboriginal patients (P < 0.001). In NSW, Aboriginal patients were younger and more likely to be female, a pattern similar to that in the NT. The outcome of ESRD treatment is not significantly different between Aboriginals and non-Aboriginals in NSW. CONCLUSION: There is a different pattern of incidence of ESRD and of outcomes with treatment among Aboriginals in NSW compared with those in the NT. A possible explanation is that the lower incidence in NSW reflects less profound socioeconomic disadvantage and better access to primary and specialist care.

Adolescent↗

PubMed2000

Who's overweight? Comparison of the medical definition and community views.

OBJECTIVE: To investigate the extent to which people who are medically defined as overweight perceive themselves to be overweight. DESIGN: Secondary data analysis of the National Health Survey and the National Nutrition Survey conducted by the Australian Bureau of Statistics in 1995. PARTICIPANTS: 10,652 people aged 18 years and over (5076 men, 5576 women) in a multistage cluster sample of households throughout Australia. MAIN OUTCOME MEASURES: Body mass index (BMI) based on measured height and weight; self-reported perception of body weight (underweight, acceptable weight, or overweight). RESULTS: Among people with a measured BMI > or = 25, 49.3% of men (95% CI, 48.1%-50.5%) and 72.0% of women (95% CI, 70.8%-73.1%) considered themselves overweight. Among those with a measured BMI < 25, 3.4% of men (95% CI, 2.8%-4.1%) and 12.4% of women (95% CI, 11.4%-13.3%) considered themselves overweight. Older women were less likely to perceive themselves as overweight than younger women. The lowest BMI at which at least half the respondents considered themselves overweight was 26 to < 27 for women aged 18-59 years, and 28 to < 29 for older women and men. CONCLUSION: For many people, particularly men and older women, the meaning of "overweight" differs from the medical definition. Clinical and public health weight reduction programs which do not take this into account are unlikely to be successful.

Adolescent↗

PubMed2005

Adverse drug reactions in older Australians, 1981-2002.

OBJECTIVE: To examine trends in adverse drug reactions (ADRs) in people aged 60 years or over causing admission to or an extended stay in Western Australian hospitals between 1981 and 2002. DESIGN AND SETTING: Secondary data analysis of case series. PATIENTS: 43,380 patients admitted to WA public and private hospitals with an (International Classification of Diseases) ICD external cause code for an ADR, identified by the population-based WA Hospital Morbidity Data System. MAIN OUTCOME MEASURES: Age-specific, age-standardised and drug-specific rates of ADR-related hospital stays. RESULTS: The age-standardised rate of ADR-related hospital stays increased from 2.5 per 1000 person-years (py) in 1981 to 12.9 per 1000 py in 2002. The largest increases occurred in those aged 80 + years (tenfold in men and sevenfold in women). The most common drug group involved was cardiovascular agents (17.5%), while anticoagulants (7.5%), cytotoxics (7.4%) and antirheumatics (6.8%) were the more specific drug classes most often implicated. ADRs from the last three classes of drugs were still rising at the end of the study, whereas ADRs from corticosteroids and antihypertensives peaked in 1996 and from opioids in 2000. CONCLUSIONS: Increases in hospital admissions or extended lengths of stay due to ADRs in WA have continued despite programs to promote rational and safer use of medicines. The sharp increase in ADRs from anticoagulants warrants attention to revised clinical guidelines.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Consumers' attitudes and behavior toward prescription drug advertising.

OBJECTIVE: To explore how consumers' characteristics interact with direct-to-consumer advertising (DTCA) to influence 2 behaviors: information seeking and asking for prescription. METHOD: A secondary data analysis was conducted using a subset of 1,102 consumers who responded to a 1998 national survey conducted by Prevention magazine. RESULTS: Being afflicted with chronic conditions and having positive attitudes toward DTCA were associated with the consumers' willingness to talk with doctors about the advertised drugs. Consumers who asked for prescriptions tended to agree that DTCA made prescription drugs appear harmless and helped them make their own decision. CONCLUSION: DTCA appears to have an influence on consumers' behavior.

Adolescent↗

PubMed2006

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Adult↗