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Biomedical subjects

B A Given

Publications and source records attributed to B A Given.

At least 37 records · Page 2Linked to original sources
PubMed1993

The cost of cancer home care to families.

BACKGROUND: For the most part, previous research on costs of cancer care has focused on the formal medical care costs. Research on home care for patients with cancer has emphasized direct care costs (expenditures). Among indirect costs, only loss of income to family members has been studied. However, a major component of indirect costs, the family labor expended to care for the patient with cancer, needs to be included for a more realistic appreciation of home care costs. METHODS: The costs of family labor are estimated by imputing monetary values for the time spent caring for the patient with cancer. The assigned monetary cost either is equated with income losses of the helper in question or is based on a putative market value of the expended labor time. In addition, out-of-pocket expenditures examined in this study cover all cancer care-related expenses for which the patient was not reimbursed by third parties. Data were obtained from a convenience sample of 192 patients with cancer and their families in lower Michigan. RESULTS: When family labor is included in the cost calculations, average cancer home care costs for a 3-month period ($4563) are not much lower than the costs of nursing home care. The substantial variation in home care costs (standard deviation [SD] = $4313) appears to be unrelated to the type of cancer diagnosis, type of treatment, or time since diagnosis but seems to be driven by the functional status of the patient and the family living arrangements. CONCLUSIONS: Outpatient care for patients with cancer coupled with greater reliance on home care appear to be economically attractive because costs to families usually are underestimated.

Adult↗
PubMed1993

Gender bias in the measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D).

Confirmatory factor-analytic models are used to examine gender biases of individual items of the Center for Epidemiologic Studies Depression (CES-D) Scale. In samples containing 708 cancer patients and 504 caregivers of the chronically ill elderly, two CES-D items are identified as producing biased responses in comparisons of male and female respondents. Three additional CES-D items are excluded on the basis of other psychometric problems, yielding a subset of 15 CES-D items that capture almost all the information of the original 20-item CES-D scale but are free of any gender bias. Gender differences in mean levels of depressive symptomatology are significantly reduced, but not eliminated, when the 15-item scale is used.

Activities of Daily Living↗
PubMed1992

Caregivers of elderly relatives: spouses and adult children.

A problem in the provision of home health care for elderly people is the limited number of family members available for caregiving. Current trends in federal, state, and local policy formation suggest an increasing emphasis on the family as an appropriate caregiver. Therefore, it is necessary to examine how family relationships affect the caregivers' responses to their caregiver situation. Data are presented from 206 caregivers enrolled in a larger longitudinal study of family members caring for elderly dependent relatives. The sample is divided into four caregiver groups: (1) spouses who have children, (2) spouses who have no children, (3) adult children who have siblings, and (4) adult children who have no siblings. Measures selected for comparison were perception of burden, caregiver involvement, affective social support, mental health status, and use of community services. Differences were found among the four groups of caregivers. Implications for social work intervention are discussed.

Adult↗
PubMed1991

Fatigue affecting family caregivers of cancer patients.

Fatigue, a universally reported symptom, may be one of the most prevalent feelings of people suffering physical or mental diseases. An understanding of the factors leading to fatigue in the caregiving population can contribute to better care and support of both the cancer patient and caregiver. The purpose of this article is to investigate and describe the experience of fatigue among caregivers of cancer patients, in relation to caregiver age, employment status, number of hours of care provided daily, duration of caregiving, and the impact upon the caregiver's schedule. A sample of 248 caregivers of cancer patients, participating in the Family Homecare Cancer Study, were surveyed regarding fatigue related to their caregiving roles. No relationship was found between severity of fatigue experienced by the caregiver of the cancer patient and caregiver age, employment status, the number of hours of daily caregiving, or the duration of caregiving. However, a significant relationship was found between fatigue and the impact of care on the daily schedule. This finding has strong implications for the oncology nurse, because the more the caregiver's schedule is a burden, the greater will be the fatigue experienced.

Activities of Daily Living↗
PubMed1988

Sources of stress among families caring for relatives with Alzheimer's disease.

We have described the different sources of stress and burden that are imposed by caring for a family member with AD. We have provided an approach to assessing each of these possible sources of stress and burden and have indicated how such assessments must take a family-based approach and consider the broader social roles and family dynamics that may color the way in which family members view and carry out their caregiving roles.

Aged↗
PubMed1984

The effects of patient characteristics and beliefs on responses to behavioral interventions for control of chronic diseases.

Tests of behavioral interventions seldom examine changes in health beliefs and behaviors thought to be prerequisites of improved outcome health states and they do not attempt to specify how patient characteristics or pretest measures influence responses to the intervention. In this study an experimental nursing intervention, its impact on hypertensive patients' beliefs about their disease, efficacy of medications and diet, as well as blood pressure and weight are described. Among patients from the experimental group, the ability of selected pretest variables to predict clinical outcomes and changes in clinical health states was evaluated. The intervention was successful in lowering diastolic blood pressure and altering certain beliefs held by the patients. The pretest characteristics were not successful in explaining hypertensive patients' responses to the intervention. Explanations for this are pursued through remarks from the content analysis of the intervention protocol. From these observations, the original health belief model was revised. The discussion concludes with a set of research questions that may prove promising for future research.

Attitude to Health↗
PubMed1983

Development of scales to measure beliefs of diabetic patients.

In this article health belief concepts are identified and previous attempts to construct scales for measuring these concepts are critiqued. Using an initial sample of 156 diabetic patients, factor analytic techniques were used to develop measures of the basic concepts of the Health Belief Model. The derived scales from this sample were cross-validated on a second sample of 92 diabetic patients. The scales were tested for unidimensionality, internal and external consistency, and stability across both samples. The application of these scales to nursing research and practice are discussed.

Adolescent↗
PubMedDate not supplied

Complementary therapy use among older cancer patients.

PURPOSE: The purpose of this study was to assess the use of complementary therapies among older cancer patients, to report patterns of use, and to understand who is more likely to use complementary therapies. DESCRIPTION OF STUDY: A survey was conducted of 699 older cancer patients at 4 weeks and 6 weeks into cancer treatment. All participants were 64 years of age or older, had received a diagnosis of breast, colorectal, prostate, or lung cancer, and were recruited from community cancer treatment centers throughout Michigan. Measures of interest included self-reported physical symptoms, depressive symptomatology, optimism, spirituality, and use of conventional and complementary health services. RESULTS: Approximately 33% of older cancer patients reported using complementary therapies. These individuals were more likely to be women, to be breast cancer patients, and to have a higher level of education. The three most frequently used therapies were exercise, herbal therapy, and spiritual healing. Complementary therapy users were significantly more optimistic than nonusers. Also, there were significant differences between users and nonusers on types of physical symptoms experienced, but no differences on reported depressive symptomatology or spirituality. CLINICAL IMPLICATIONS: Oncology providers need to be aware that one third of their older patients are likely to supplement conventional care with complementary therapies. Therefore, providers should be knowledgeable about the safety and efficacy, in particular, of various exercise programs, herbal and vitamin therapies, and spiritual healing. It would be beneficial to develop a system within cancer centers by which patients could easily report on their use of complementary therapies, allowing providers to work in partnership with their patients.

Aged↗
PubMedDate not supplied

Social vulnerability and reactions to caregiving in daughters and daughters-in-law caring for disabled aging parents.

Variables that have been conceptually linked with social vulnerability--income, educational level, employment, cessation of work to provide care, marital status, social support, and health--were used to predict four categories of reaction to caregiving in 159 daughters and daughters-in-law caring for their disabled aging parents. Social support, income, and health best predicted negative reactions to caregiving; social support alone best predicted negative reactions to caregiving; social support alone best predicted feelings of family abandonment, impact on health, and impact on schedule. Compared with daughters and daughters-in-law who had not quit work to provide care, those who had quit work were significantly older, had lower incomes and fewer social supports, and were more involved in care. The results suggest that quitting work may be a precursor to social isolation that places the caregiver at increased risk for social vulnerability and negative reaction to caregiving. The implications of the findings for health care policy are discussed.

Aged↗
PubMedDate not supplied

Research design and subject characteristics predicting nonparticipation in a panel survey of older families with cancer.

BACKGROUND: While recognized that loss of subjects over time may introduce bias and complicate statistical analysis in panel studies, it is seldom acknowledged that sampling bias starts with subjects who are eligible but do not participate. OBJECTIVES: Community-based recruiters identified 1,948 subjects as eligible to participate in a descriptive panel survey of older families with cancer. Focusing on the time between identification of eligible subjects until contact for the first interview for consenting subjects, the purpose of this study was to determine if subject or research design factors predicted who was more prone to nonparticipation. METHOD: A multivariate model explored the simultaneous effects of subject and research design characteristics on nonparticipation. Demographic and cancer characteristics, as well as features of the study protocol, were used as predictors in a multinomial logit regression model to enable a three-way comparison between nonconsenters (n = 748), consenters who dropped out prior to data collection (n = 208), and consenters who participated in the intake interview (n = 992). RESULTS: Age and cancer diagnosis played roles in whether consent was obtained, whereas race did not affect consent but raised odds of drop out after consent. Powerful evidence emerged that design features, such as if a caregiver participated, recruitment staff roles, and payment to recruiters, affected the probability of subjects not participating or dropping out before being interviewed. CONCLUSIONS: Findings suggest that both subject and research design characteristics affect the likelihood of nonparticipation in a panel study of older cancer patients and family caregivers. Future research involving testing of strategies addressing access and accrual issues, research staff roles, reimbursements, and responsiveness to the needs of research personnel, ill participants, and family members is warranted.

Age Factors↗
PubMedDate not supplied

Family support in advanced cancer.

Changes in the health care system have resulted in a shift of cancer care from the in-patient arena to ambulatory and home settings. This shift has likewise translated into increased family involvement in the day-to-day care of the person with cancer. Cancer patients have multifaceted needs, including disease and treatment monitoring, symptom management, medication administration, emotional support, assistance with personal care, and assistance with instrument care. Family caregivers may be ill prepared to assume these tasks, requiring information on the disease and treatment, as well as instruction in technical and care skills. Moreover, caregiving must be balanced against already established roles and role responsibilities. In addition, family caregivers have their own emotional responses to the patients' diagnosis and prognosis, and may require coaching and emotional support themselves. The health care system can facilitate positive outcomes by embracing the family caregiver as a partner in the health care team, providing instruction and guidance to the caregiver as he/she assumes this role, and evaluating the home care situation. Research to date has only scratched the surface of testing interventions that meet the needs of the cancer caregiver. A research agenda is proposed to more fully elucidate the cancer caregiver's experience throughout the illness and treatment trajectory, and identify the means to effecting positive outcomes for the person with cancer, their family caregiver, and the health care system.

Caregivers↗
PubMedDate not supplied

Compliance among patients with cancer.

Although there has been substantial progress in the effectiveness of cancer treatment and more patients experience longer-lasting remissions or cure, a substantial number of individuals still fail to respond to treatment. Healthcare professionals now are investigating patient behaviors which may result in ineffective response to potentially curative regimens. Patient perceptions, disease and treatment factors, sociodemographic characteristics, and social support systems influence the patient's decision to comply with a treatment regimen.

Humans↗