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Biomedical subjects

S Weinrich

Publications and source records attributed to S Weinrich.

15 recordsLinked to original sources

An intervention to decrease cancer fatalism among rural elders.

PURPOSE/OBJECTIVES: To evaluate the effectiveness of a video intervention in decreasing cancer fatalism, increasing knowledge of colorectal cancer, and increasing participation in fecal-occult blood testing (FOBT). DESIGN: Repeated measures, pretest/post-test. SETTING: Senior citizen centers in a rural southern state. SAMPLE: Individuals were selected and assigned to the study group based on the center they attended. Centers were selected and assigned randomly to an intervention (n = 42) or control (n = 28) group. The age of the participants ranged from 52-92 years (X = 75). METHODS: Pretest measures included the Powe Fatalism inventory, the Colorectal Cancer Knowledge Questionnaire, and the Demographic Data Questionnaire. The intervention group viewed the Medical University of South Carolina's video Telling the Story ... To Live is God's Will, and the control group viewed the American Cancer Society (ACS) video Colorectal Cancer: The Cancer No One Talks About. Hemoccult II kits were distributed to both groups at no cost. Post-test data were collected using the Powe Fatalism Inventory and the Colorectal Cancer Knowledge Questionnaire. MAIN RESEARCH VARIABLES: Cancer fatalism, knowledge of colorectal cancer, and participation in FOBT. FINDINGS: People who viewed the intervention video had a greater decrease in cancer fatalism scores and a greater increase in knowledge of colorectal cancer scores than the control group. Both groups had greater than 60% participation in FOBT. CONCLUSIONS: Telling the Story ... To Live is God's Will is an effective, self-contained, cost-effective intervention to decrease cancer fatalism and increase knowledge of colorectal cancer. The video was as effective as the ACS video on colorectal cancer in increasing participation in FOBT among rural elders. But, because Telling the Story ... To Live is God's Will also decreases cancer fatalism and increases knowledge, the potential exists for the increased screening behaviors to be maintained over time. IMPLICATIONS FOR NURSING PRACTICE: Showing the video in waiting areas of community health centers to facilitate the discussion of colorectal cancer and cancer screening with the healthcare professional is a possibility. Nursing students may benefit from using the video as a model for the integration of beliefs and attitudes in developing culturally appropriate, community-based interventions. More research is needed to determine if the positive outcomes of the intervention (i.e., decreased cancer fatalism, increased knowledge, increased participation in colorectal cancer screening) can be maintained over time.

Black or African American↗

Prostate cancer education in African American churches.

The use of churches as recruitment sites of African Americans into health promotion activities is a popular theme in the 1990s literature. This research measured the impact of previous exposure to cancer on participation in an educational program and a free prostate cancer screening. Cues to action from the Health Belief Model provided the conceptual framework. Over 500 men attended a prostate cancer educational program at their church. Men who participated in the educational program and completed the questionnaire were given a voucher that they could take to their doctor of choice for a free prostate cancer examination. Having a member of the congregation who was previously diagnosed with cancer was a significant cue to attendance at the educational program (P = 0.03). Recommendations for future cancer screening in churches are given.

Black or African American↗

Agitation: measurement, management, and intervention research.

Strategies for controlling and managing agitation of patients in long-term care populations has been identified as a research priority. Unfortunately, there is a paucity of literature on empirically tested therapeutic interventions for agitation. This manuscript summarizes the literature related to the measurement, management, and interventions for agitation and identifies a nursing research agenda for conducting research in this area. Nonpharmacological and nonrestraint interventions are highlighted and categorized by (1) alterations in care given, (2) environmental adaptations, and (3) behavioral approaches. Future research areas identified by the authors focus on additional types of environmental, interpersonal, and behavioral interventions as well as theoretical predictors of agitation; the influence and role of nursing personnel and caregiver; and the legal and ethical issues involved in caring for patients who manifest agitation.

Dementia↗

Predictors of Pap smear screening in socioeconomically disadvantaged elderly women.

OBJECTIVE: The objective for this study was to identify predictors for participation in Pap smear screening in a socioeconomically disadvantaged older population. DESIGN AND SAMPLE: A cross-sectional survey design was used to examine data from 238 southern women 50 years of age and older who were recruited from 24 randomly selected congregate meal sites of the Council on Aging. MEASUREMENTS: The 45-item questionnaire covered demographics, Pap smear screening history, and colorectal cancer screening history. RESULTS: Among this older, very low income population, women who had never had Pap smears (17.2%) were significantly more likely to have no phone or to be unable to use a phone (adjusted odds ratio (aOR) = 4.1; 95% confidence interval (CI) 1.6-10.6), to have annual incomes of less than $5,800 (aOR = 3.1; 95% CI 1.1-9.0), to be widowed (aOR = 2.8; 95% CI 1.1-7.3), to have no family history of cancer (aOR = 3.3, 95% CI 1.3-10.0), to report having never had a rectal examination (aOR = 5.4, 95% CI 1.8-16.0), and not to have participated in a free fecal occult blood testing program (aOR = 5.0, 95% CI 2.0-10.0). CONCLUSIONS: These data, unique in including very low income (< $10,000) and older women (65 and over), found that income and access to a phone were strongly correlated with cervical cancer screening participation. Women who lacked external incentives for screening (being widowed and not having a family history of cancer) were less likely to obtain screening. This study's finding that "not having a phone" was a strong predictor for nonparticipation in cervical cancer screening has implications for national telephone-derived estimates of cervical cancer screening.

Age Factors↗

Delirium in the older person with cancer.

Delirium occurs in 25-40% of patients with cancer and in as many as 85% of patients with advanced cancer. Delirium, or acute confusion, can be short term and reversible and differs from dementia, which is chronic and irreversible. Accurate assessment is critical for effective treatment and to reduce the increased mortality associated with delirium. Assessment for differentiating depression as well as dementia is needed, because mistaken diagnoses often prolong and exacerbate the symptoms of delirium. Different treatment strategies are appropriate depending on the cause(s) of confusion. In this article, risk factors and assessment tools are reviewed, and interventions for delirium in older persons with cancer are presented. Future areas for research are identified, because there is a paucity of research on delirium in older patients with cancer.

Aged↗

Psychological distress of adolescents exposed to Hurricane Hugo.

To ascertain the effects of a natural disaster on adolescents, 1482 South Carolina high school students who were exposed to Hurricane Hugo were surveyed 1 year after the disaster. Subjects completed a self-administered questionnaire measuring Hugo exposure, nonviolent and violent life events, social support, self-efficacy, and psychological distress. Results showed that the students reported minimal exposure to the hurricane and psychological distress variables approximated national norms. As exposure increased, adolescents reported increased symptoms of psychological distress; i.e., anger, depression, anxiety, and global mental distress. Females and white students experienced higher levels of distress. In most cases, other stressful life events were at least as strong a predictor of psychological distress as was exposure to the hurricane. Self-efficacy and social support were protective.

Adolescent↗

Post-traumatic stress disorder in adolescents after a hurricane.

A school-based study conducted in 1990, 1 year after Hurricane Hugo, investigated the frequency and correlates of post-traumatic stress disorder (PTSD) in 1,264 adolescents aged 11-17 years residing in selected South Carolina communities. Data were collected via a 174-item self-administered questionnaire that included a PTSD symptom scale. A computer algorithm that applied decision rules of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised to the symptoms reported was used to assign a diagnosis of PTSD and to designate the number of individuals who met the reexperiencing (20%), avoidance (9%), and arousal (18%) criteria. Rates of PTSD were lowest in black males (1.5%) and higher, but similar, in the remaining groups (3.8-6.2%). Results from a multivariable logistic model indicated that exposure to the hurricane (odds ratio (OR) = 1.26, 95% confidence interval 1.13-1.41), experiencing other violent traumatic events (OR = 2.46, 95% confidence interval 1.75-3.44), being white (OR = 2.03, 95% confidence interval 1.12-3.69) and being female (OR = 2.17, 95% confidence interval 1.15-4.10) were significant correlates of PTSD.

Adolescent↗

Nurses respond to Hurricane Hugo victims' disaster stress.

Hugo, a class IV hurricane, hit South Carolina September 22, 1989, and left behind a wake of terror and destruction. Sixty-one nursing students and five faculty were involved in disaster relief with families devastated by the hurricane. A review of the literature led these authors to propose a formulation of the concept of disaster stress, a synthesis of theories that explains response to disaster as a crisis response, a stress response, or as posttraumatic stress. With the concept of disaster stress serving as a theoretical foundation, the nurses observed, assessed, and intervened with one population of hurricane Hugo victims, noting their immediate psychosocial reactions and coping mechanisms. Victims' reactions to disaster stress included confusion, irritability, lethargy, withdrawal, and crying. The most frequently observed coping strategy of these hurricane Hugo victims was talking about their experiences; other coping tactics involved humor, religion, and altruism.

Aged↗

The problem of front-back localization in binaural hearing.

Some investigations concerning the problem of front-back discrimination in normal hearing are described. Three groups of experiments are included: Some objective measurements of transfer functions of the ears of four subjects, horizontal plane simulations and modifications of artificial-head signals in order to bring about directional inversions in the horizontal plane. It is concluded that subjects are able to utilize small individual characteristics in the transfer functions of their own outer ears to distinguish between front and back.

Adult↗

Group protocol to mitigate disaster stress and enhance social support in adolescents exposed to Hurricane Hugo.

Literature reports that cognitive understanding and social support can mitigate stress in both adults and adolescents. As a subcomponent of the Carolina Adolescent Health Project (CAHP), this research evaluated the efficacy of a Cognitive Social Support (CSS) group protocol designed to mitigate the disaster stress of adolescents who had been exposed seriously to Hurricane Hugo. A purposive sample of 259 students participated in and evaluated the CSS. This article reports the specific structure, content, process, rationale, and cost of the CSS. Evaluations indicated that 82% of the students evaluated the small-group component of the CSS as "very good" or "excellent," while 70% rated the large-group component as "very good" or "excellent."

Adolescent↗

Self-efficacy in normal adolescents.

This descriptive study, one component of the Carolina Adolescent Health Project (CAHP), measured self-efficacy in a voluntary sample of 432 normal freshmen and sophomore urban high school students. Using Coppel's Self-Efficacy Scale (SES), which is based on Bandura's conceptualization of self-efficacy, the research also examined the effect of gender, race, socioeconomic status, and self-reported religiosity on self-efficacy. The teenagers in this sample had a moderately high degree of self-efficacy with a mean SES score of 45.37 (SES range = 13-65). A series of t tests and one-way and two-way analyses of variance indicated no significant difference in SES scores by race, gender, socioeconomic status, or religiosity. Findings did not support the investigators' original expectation that these demographic and psychosocial variables would affect self-efficacy. The study provides normative data for future comparative studies using the SES.

Adolescent↗

Barriers to prostate cancer screening in African American men.

Prostate cancer is one of the most significant health problems facing men today, especially African American men. Decreased participation in prostate cancer screening by African American men is a serious problem, as decreased survival rates occur when the diagnosis of prostate cancer is delayed. This descriptive correlational study focuses on identifying the relationship between perceived barriers and participation in a free prostate cancer screening program. A purposive sample of African American men (n = 1,395) was drawn from multiple community sites in the southeast United States. All significant variables (age, income group, marital status, and educational intervention were used as covariants for the multiple logistic regression. With the addition of the covariants, the barrier suggesting "would be embarrassed" remained significant (p = 0.03). Two other barriers, "no way to get there" and "refuse to go" approached significance (p = 0.08 and p = 0.09, respectively). Nurses can use knowledge about barriers identified in this study to develop interventions aimed at increasing participation in prostate cancer screening among African American men.

Adult↗