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Biomedical subjects

Lynda G Balneaves

Publications and source records attributed to Lynda G Balneaves.

13 recordsLinked to original sources
PubMed2006

The influence of significant others in complementary and alternative medicine decisions by cancer patients.

Individuals living with cancer are faced with numerous treatment decisions that encompass both conventional therapies and complementary and alternative medicine (CAM). Although a beginning body of research has explored the CAM decision-making process by cancer patients, the social context of these treatment decisions has been largely ignored. As a part of a larger grounded theory research project exploring CAM decision-making processes of cancer patients living in British Columbia, Canada, the purpose of this secondary inquiry was to explore how significant others were involved in patients' decisions related to CAM. In total, 61 patients with early and advanced-stage breast and prostate cancer and 31 significant others participated in semi-structured interviews. Using constant comparative analysis, four main types of decisional involvement by significant others were identified: creating a safe place for the patient to make a decision, "becoming a team": collaborative decision-making, moving the patient towards a decision, and making the decision for the patient. Significant others were often found to engage in more than one type of decision involvement as a consequence of several key factors. Within the types of decisional involvement, nine distinct roles in the CAM decision-making process were described by the significant others. The findings of this inquiry extend previous research by highlighting the importance of significant others in cancer patients' CAM decisions and challenge past conceptualizations of autonomy in treatment decision making.

Aged↗
PubMed2006

Physical and emotional health effects and social consequences after participation in a low-fat, high-carbohydrate dietary trial for more than 5 years.

PURPOSE: Little is known about the potential adverse effects of interventions to reduce dietary fat. We examined the physical and emotional health effects, and social consequences experienced by women at high risk for breast cancer who had participated in a low-fat diet intervention, randomized, controlled trial for at least 5 years. METHODS: Participants in the Canadian Diet and Breast Cancer Prevention Trial from British Columbia were mailed a survey questionnaire that included the validated Medical Outcomes Study 36-item Short Form Health Survey (SF-36) and Women's Health Questionnaire (WHQ), and a series of questions on health-related and social constructs. Responses were compared between the diet intervention and control groups by menopausal status. RESULTS: Completed questionnaires were returned by 359 women in the diet intervention group and 382 in the control group. No significant differences were found between these groups for SF-36 and WHQ health outcomes, hair/nail changes, physical activity levels, family/friend support levels, and doctor visits. Significantly more women in the intervention group reported taking products for arthritis (other than pain medication), greater difficulty in maintaining eating habits in social situations and at work, greater stress, and guilt related to personal eating habits. These findings persisted for both premenopausal and postmenopausal women. CONCLUSION: Changes resulting from a low-fat diet intervention can be incorporated into women's daily lives with limited long-term negative effects.

Arthritis↗
PubMed2006

Levels of commitment: exploring complementary therapy use by women with breast cancer.

OBJECTIVES: Previous research on complementary therapy use in populations of patients with breast cancer has failed to differentiate among the different types of therapies and utilization patterns, resulting in wide discrepancies in prevalence rates. The purpose of this study was to develop more refined and rigorous estimates of the prevalence of complementary therapy use in women with breast cancer and their level of commitment to complementary therapy. DESIGN AND SAMPLE/SETTING: Using a cross-sectional, retrospective survey design, a random sample of 334 women with breast cancer was drawn from a Canadian provincial cancer registry. Using an intensive therapy inventory, women were asked to indicate the therapies and practices they had used since cancer diagnosis, frequency of use, amount of effort associated with using each therapy, and financial cost of therapy use. RESULTS: A substantial proportion of women with breast cancer were found to be using complementary therapies, with between 19.5% (most conservative estimate) and 79.9% (liberal estimate) of the women reporting the use of at least one complementary therapy following diagnosis. While the majority of therapies were used on a daily basis, a minimal amount of effort and finances was expended on complementary therapy use. Using two-way cluster analysis, two homogenous groups of complementary therapy users were identified based on level of commitment to complementary therapy use. Women with a low commitment to complementary therapy use comprised 73.9% of the sample and were more likely to be older and report less education than women with a moderate-to-high commitment to complementary therapy use. CONCLUSIONS: The use of complementary therapies by women with breast cancer warrants more precise measurement to accurately capture the types of complementary therapies used and the level of commitment to complementary therapy use. The findings of this study point to the value of the concept of commitment in identifying individuals willing to commit substantial time, energy and financial resources to complementary therapy use.

Adult↗
PubMed2005

Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review.

PURPOSE: To conduct a systematic review of reasons for and sociodemographic and disease characteristics associated with complementary and alternative medicine (CAM) use in cancer patients. METHODS: Eligible studies were identified by searching the following databases: Alt Health Watch, AMED, CINAHL, CancerLit, PremMEDLINE, MEDLINE, Pub-Med, Ingenta, EMBASE, and Health Star, as well as reference lists in review articles. Only English-language articles published between 1994 and 2004 were included. Search terms included CAM and oncology/cancer, decision making and CAM and oncology/cancer, treatment decision making and CAM and oncology/cancer, and health care choices and CAM and oncology/cancer. RESULTS: Fifty-two eligible studies were identified and summarized. These studies were conducted in 14 different countries, with the largest number of studies being completed in the United States (34.6%). A therapeutic response, wanting control, a strong belief in CAM, CAM as a last resort, and finding hope were the most commonly cited reasons for using CAM. Age, socioeconomic status, and gender were the dominant characteristics associated with CAM use. CONCLUSION: Reasons for and characteristics associated with CAM use among cancer patients have been studied extensively. Future CAM research among cancer patients should focus on identifying decision-making processes and building theoretical decision-making models. These can be used in the development of decisional aids for patients when confronted with the choice to use CAM as part of their cancer treatment.

Adult↗
PubMed2005

Canadian nursing in the genomic era: a call for leadership.

With developments in genomics, there is an urgent need for Canadian nurses in all settings to be informed and involved in the incorporation of this new knowledge into healthcare. The purpose of this paper was to synthesize the literature on genetic nursing roles to provide a foundation for Canadian nursing leaders as they take on the challenges of nursing in the genomic era. A comprehensive review of 98 articles published between 1994 and 2004 revealed strong support for genetic nursing roles and recommendations for levels of genetic nursing practice. The few studies on genetic nursing roles suggested that nurses and other health professionals support the integration of genomics into nursing practice. Issues that need to be addressed related to nursing practice, education and research are offered to engage nursing leaders in advocating for the incorporation of genomics into nursing in Canada.

Canada↗
PubMed2005

Establishing roles in genetic nursing: interviews with Canadian nurses.

The purpose of this qualitative study was to describe nurses' roles in providing clinical genetic services related to adult onset hereditary disease and factors that influence genetic nursing practice in Canada. The study involved semi-structured telephone interviews with 22 nurses from 5 Canadian provinces with full-time or part-time roles in providing genetic services. The interviews included open-ended questions to elicit descriptions of genetic nursing roles and factors that support and limit opportunities in genetic nursing practice. Thematic analysis of the transcribed interviews revealed that, in addition to genetic counselling, the nurses reported a wide range of roles and responsibilities related to the provision of genetic services that drew directly on their nursing background (e.g., patient assessment, health promotion). Factors identified as supporting genetic nursing roles included nursing background, being part of a multidisciplinary team, and receiving mentorship. Challenges in establishing roles in genetic nursing were related to role ambiguity, lack of recognition of nursing expertise, limited availability of genetics education, isolation, and instability of nursing positions. Recommendations to support the development and expansion of genetic nursing practice were identified. A coordinated national effort among all stakeholders is needed to provide the resources necessary to support the appropriate and effective use of nursing expertise as genetics is integrated into the Canadian health-care system.

Adult↗
PubMed2004

Unraveling women's perceptions of risk for breast cancer.

Inconsistent reports of the prevalence of risk perception accuracy may be related to the use of different classification strategies. The purpose of this study was to compare two approaches for assessing the accuracy of women's breast cancer risk perceptions. A telephone survey was conducted with an age-stratified random sample of British Columbian women 20-79 years of age without a breast cancer diagnosis (n = 761). A comparison of two methods employed to determine perception accuracy revealed substantial differences between the methods with regard to the classification of women as under- and over-estimators. The study highlights the need for researchers to consider the method used to determine the accuracy of risk perceptions and the implications of using different strategies to assess risk perception accuracy when such information is used in research or to guide interventions.

Adult↗
PubMed2002

Women's interest in genetic testing for breast cancer risk: the influence of sociodemographics and knowledge.

The objective of this study was to assess women's interest in genetic testing for breast cancer risk. Randomly selected samples of 761 women without breast cancer from the general population of British Columbia, Canada, and 260 women with breast cancer from the provincial cancer registry participated in a telephone survey that assessed interest in genetic testing for breast cancer risk, knowledge of hereditary breast cancer and genetic testing, and sociodemographics. Women with breast cancer did not possess superior knowledge of breast cancer genetics compared with women from the general population. Of the women with breast cancer, 30.8% reported interest in testing or had been tested, compared with 28.5% of women without breast cancer. Controlling for differences in age, education, personal history of breast cancer, and knowledge of genetics, women with at least one relative with breast cancer were 2.3 times more likely to express interest in genetic testing for breast cancer risk than those with no family history. There were significant interactions between breast cancer status and education and between age and knowledge of breast cancer genetics. Women without breast cancer and with a positive family history, who were between 20 and 40 years of age, were most likely to be interested in testing. The women with breast cancer who were interested in testing tended to be approximately 50 years of age, had a positive family history, and had more years of education. Women with a family history of breast cancer, well-educated women with breast cancer, and younger women, particularly those with knowledge of genetic testing, are important target audiences for community-based education on genetic testing for breast cancer risk.

Adult↗
PubMedDate not supplied

The influence of question wording on assessments of interest in genetic testing for breast cancer risk.

The purpose of this study was to compare the results of different measures of interest in genetic testing for breast cancer risk. A telephone survey of a random sample of women without breast cancer was conducted in British Columbia, Canada. Interest in genetic testing for breast cancer risk was measured in three ways: (1) an unprompted assessment of interest, (2) assessment of interest when prompted with a hypothetical offer of testing, and (3) assessment of interest when provided with supplementary information. Substantial differences in reported levels of interest in genetic testing were observed across the different assessment approaches, with the unprompted assessment of interest resulting in lowest levels of interest. The highest levels of interest were observed when the assessment of interest was prompted with a hypothetical offer of testing. Factors predicting interest in genetic testing varied depending on the assessment measure used. These findings suggest that more attention must be given to measurement issues, including complete reporting of measures used in research, development of standardized approaches to assessing interest in genetic testing, and more rigorous psychometric evaluations of measures of interest in genetic testing.

Adult↗
PubMedDate not supplied

Family support of immigrant Punjabi women with breast cancer.

Women with breast cancer have been found to rely heavily on family members for providing support during their illness experiences. There has been limited research on ethnocultural families' experiences of illness and how these families respond to a diagnosis of breast cancer. This study examined the experiences and responses of family members of immigrant Punjabi women diagnosed with breast cancer. Through interviews with 19 Punjabi women diagnosed with breast cancer and 18 family members, key practical and emotional support strategies were described. Recommendations for culturally appropriate, family-centered models of care are provided that acknowledge breast cancer as a family event.

Adaptation, Psychological↗
PubMedDate not supplied

A Pap test screening clinic in a South Asian community of Vancouver, British Columbia: challenges to maintaining utilization.

The purpose of this article is to describe experiences and challenges in establishing a South Asian Pap Test Clinic. The specialized Pap test clinic for immigrant South Asian women was a community-initiated response to high rates of cervical cancer within this population. Efforts were made to ensure that the clinic provided health services in a sensitive and culturally appropriate manner. Although women were generally positive about their experiences at the South Asian Pap Test Clinic and often encouraged other women to attend the clinic for Pap testing, attendance patterns have not been maintained. The three most significant challenges to the clinic's ongoing success were: (1) maintaining the continued involvement of stakeholders in developing long-term strategies to enhance community awareness about cervical cancer; (2) creating mechanisms to strengthen support from physicians in the community; and (3) meeting the needs of the underserved within a specialized health service for South Asian immigrant women. These challenges provide important lessons for others to increase the participation of immigrant women in screening practices. Nurses can play a key role in mobilizing and maintaining collaborations that are essential to the continuing success of community-based programs.

Adult↗
PubMedDate not supplied

Women's perceptions of breast cancer risk: are they accurate?

BACKGROUND: The objective was to compare women's personal estimates of their risk with objective breast cancer risk estimates and to describe the risk factors for breast cancer identified by women. METHODS: Telephone survey of a random sample of 761 rural and urban women with no history of breast cancer. Survey instrument included measures of perceptions of lifetime risk for breast cancer for themselves and for the average woman, perceptions of risk factors that influenced their risk and the average woman's risk for breast cancer. Objective estimates of breast cancer risk were calculated using the Gail et al. algorithm. Descriptive statistics and multiple linear regression were used to analyze the data. RESULTS: Women's estimates of their own lifetime risk for breast cancer were significantly higher than their Gail model risk estimates (mean difference = 19%, p < 0.001). The women's personal breast cancer risk estimates were lower than estimates of risk for a hypothetical average woman (mean difference = -8%, p < 0.001). Fifty percent of the sample reported a perceived risk estimate at least 15% above their Gail risk estimate. The risk factors for breast cancer most frequently identified included family history, nutrition/diet, smoking, lifestyle, environment, stress and age. Although the risk factors used to calculate the Gail model risk estimates were reported by some study participants, these women consistently identified only family history as their personal risk factor. CONCLUSION: Women have difficulty accurately estimating their breast cancer risk and identifying known risk factors for breast cancer. Individual risk information may be more useful in enhancing accurate risk perceptions than the "1 in 9" message.

Adult↗