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PubMed2006

[Acceptance of chemotherapy by Brazilian women with breast cancer].

INTRODUCTION: Breast cancer has the second highest incidence and is the first cause of death by cancer among Brazilian women. Under the physician's perspective chemotherapy should be indicated according to the risk benefit ratio in each case. However, from the Brazilian breast cancer patient's perspective this risk benefit ratio requires further classification. OBJECTIVE: In patients with breast cancer who have already received chemotherapy evaluate the minimum benefit considered necessary for a renewed administration and learn which factors may influence this decision. METHODS: we surveyed 53 patients comprising general, clinical and cancer related variables, as well as issues related to the minimal expected benefit which would induce the patient to agree to undergo chemotherapy. RESULTS: 75% would accept to receive chemotherapy again even if it would not change their probability of relapse, 50% would accept chemotherapy again, even though it would not increase survival rates. Similarly, 81.54% would submit once more to chemotherapy even though it would not increase their probability of cure. Acceptance of a new chemotherapy treatment yielding minimal benefits correlated significantly with more age, with a lower educational level and with no previous administration of Adriamycin. CONCLUSION: Even with a minimal benefit, the majority of formerly treated breast cancer patients are willing to submit to another chemotherapy treatment.

Adult↗
PubMed1991

Patient and staff acceptance of robotic technology in occupational therapy: a pilot study.

While the majority of applications of robotics in the field of rehabilitation focus on the development of smart aids for people without upper extremity function, there is also potential for the robot as a therapy "aide." We designed, built, and pilot-tested hardware and software that used a robot to provide muscle reeducation movement patterns after stroke. This is a report on a field trial, in which 11 occupational therapists used the system with 22 patients; each patient averaged 2.2 sessions. Based on information contained in the system database, a log, patient interviews, and therapist questionnaires, we evaluated safety, system utility, and patient and therapist acceptance. The results suggest that robotic treatment is safe and accepted (if not welcomed) by patients. The therapists expressed a qualified acceptance, suggesting several modifications to increase utility. The potential for the application of robotics in rehabilitation therapy is discussed in light of these findings.

Attitude of Health Personnel↗
PubMed1989

The acceptance and completion of mammography by older black women.

We assessed the relation of patient characteristics, knowledge and beliefs to the utilization of mammography in an inner-city setting by 187 Black women over the age of 50. Thirty per cent of those who were offered mammography initially declined the offer and 40 per cent were subsequently unable to complete the procedure. Patient interviews were used to derive 27 potential knowledge and health belief predictor scales. In multiple regression analysis, two health belief scales and two knowledge scales accounted for 15 per cent of the observed variance in the model of acceptance. The strongest predictor of subsequent completion was initial acceptance. The presence of breast symptoms and two health belief scales together with initial acceptance accounted for 26 per cent of variance in the model of completion. These results suggest that the successful accomplishment of mammography requires coordinated efforts at the level of the provider, patient, and setting. Health beliefs may influence the patient's behavior in this process, but their effect appears to be modest.

Black or African American↗
PubMed2005

Oncologist Assisted Spiritual Intervention Study (OASIS): patient acceptability and initial evidence of effects.

PURPOSE: Individuals with serious illness often desire to discuss spiritual concerns with their physician, yet substantial barriers exist to doing so, including limited evidence of value. This study evaluated acceptability, impact on satisfaction with care and on quality of life (QOL) of a brief (5-7 minute) semi-structured exploration of spiritual/religious concerns. PATIENTS AND METHODS: 118 consecutive patients of four oncologist-hematologists (95% recruitment; 55.1% female, 91.5% Caucasian, 81.3% Christian) with mixed diagnoses, duration (51.7% diagnosed within 2 years) and prognosis (54.2% in active treatment) were alternately assigned to receive the intervention or usual care during an office visit. Assessment occurred just prior to the visit, immediately after, and after 3 weeks. Measures included the FACT-G QOL and FACIT-Sp (Spiritual Well-Being) Scales; BSI Depression Scale; the PCAS Interpersonal and Communication scales; and ratings of acceptability. RESULTS: Oncologists rated themselves as comfortable during the inquiry with 85% of patients. Of patients, 76% felt the inquiry was "somewhat" to "very" useful. At 3 weeks, the intervention group had greater reductions in depressive symptoms (F= 7.57,p < .01), more improvement in QOL (F = 4.04, p < .05), and an improved sense of interpersonal caring from their physician (F = 4.79, p < .05) relative to control patients. Effects on QOL remained after adjusting for other variables, including relationship to physician. Improvement on Functional Well-being was accounted for primarily by patients lower on baseline spiritual well-being (beta = .293, p < .001). CONCLUSIONS: This study supports the acceptability of a semi-structured inquiry into spiritual concerns related to coping with cancer; furthermore, the inquiry appears to have a positive impact on perception of care and well-being.

Adult↗
PubMed1990

Perceived control and acceptance of the decision to enter a nursing home as predictors of adjustment.

A longitudinal study of newly admitted nursing home residents examined the effects of perceived control over the relocation decision and acceptance of the relocation in general as determinants of changes in functional health and morale. Perceived control had positive effects on health during the first month of residency but negative effects on health and morale between the second and fourth months. On the other hand, acceptance had positive effects on both health and morale between the second and fourth months. Perceived control over the relocation process appears to have short-term benefits but long-term costs, whereas acceptance appears to be a separate and important coping function.

Aged↗
PubMed2005

College students' acceptance of potential treatments for ADHD.

The purpose of the current study was to investigate the influence that the professional occupation of a consultant making a treatment recommendation may have on college students' (82 women and 52 men) acceptance of a proposed treatment for a child displaying characteristics of Attention Deficit/Hyperactivity Disorder. Consultants were special education teachers, school psychologists, or physicians. The study also examined college students' ratings of treatment acceptability associated with three frequently implemented interventions of either nonspecific medication, token economy with response cost, or time-out for children with characteristics of Attention Deficit/Hyperactivity Disorder. Analysis indicated college students found a token economy intervention was the least acceptable recommendation by a physician.

Adult↗
PubMed1982

Oral status and acceptance of dental services among some elderly persons in Oslo.

Oral conditions were studied clinically and radiographically in a group of people aged 67-94 years. The group comprised 70 persons living in an institution for elderly people and 111 persons living in their homes in the surrounding area. The participants were classified according to sex, age and former occupation. The examination was carried out in a dental office established at the institution. 63% of the participants were dentulous with a mean number of 13 teeth. Almost 50% of the teeth were previously restored and 13% of the teeth were decayed at the examination. 45% had complete maxillary dentures and 39% had complete mandibular dentures. The need for dental treatment according to defined criteria was registered, and treatment-offers were given. Comparisons were made between the treatment suggested and the treatment actually given. Of the total group, 129 persons needed dental treatment. Of these, 65 persons accepted all or part of the treatment suggested. In general, sex was not a good predictor of the need for an acceptance of dental services. However, age was found to be useful as a predictor. Social background was an unreliable predictor of the need for and acceptance of dental services.

Age Factors↗
PubMed1983

A disposable uroflowmeter for recording of maximum flow rate. Accuracy and clinical acceptability.

A disposable urinary flowmeter (Peakometer) was evaluated in regard to accuracy of measurement and acceptability by patients. Laboratory tests of measurement accuracy were made with five Peakometers as recordings of maximum flow rate and voided volume. The accuracy was found to be acceptable. A minimum voided volume of 200 ml is recommended for a reasonably exact recording of maximum flow rate. Ten patients aged 28-86 years tested the acceptability of the Peakometer. All were able to use the apparatus correctly and to register maximum flow rate and voided volume of urine in accordance with written standardized instructions. The disposable flowmeter can be recommended for patients who live far from their hospital, thus saving time and transport costs. Clinics with relatively few patients requiring urinary flow studies may use the disposable flowmeters, instead of investing in relatively expensive electronic apparatus.

Adult↗
PubMedDate not supplied

Patient acceptance and the psychological effects of women experiencing telecolposcopy and colposcopy.

BACKGROUND: The purpose of the study was to assess patient acceptance and psychological effects in women experiencing telecolposcopy compared with colposcopy. METHODS: Convenience samples of 150 and 263 women scheduled for colposcopy or telecolposcopy, respectively, completed questionnaires assessing anxiety (Prime MD), depression [Center for Epidemiologic Studies/Depressed Mood Scale (CES-D)], health beliefs and concerns, coping style (Miller Behavioral Style Score) and examination acceptance and satisfaction. Test scores and subject responses were compared using the t test and Wilcoxon rank sum test. RESULTS: Mean scores representing mild anxiety (1.3 and 1.2, P =.7) and mild depression (35.4 and 36.3, P =.4) were reported for the telecolposcopy and colposcopy groups, respectively. The telecolposcopy group indicated significantly greater mean scores for the examination, saving them time and money compared with the colposcopy group. Women in both groups were highly satisfied with their examinations and care. CONCLUSIONS: In general, women reported very high levels of satisfaction with telecolposcopy and colposcopy. Potential savings of time and money and improved health care were considered of particular value to women examined by telecolposcopy. Telecolposcopy seems to be well accepted by rural women.

Adaptation, Psychological↗
PubMed1987

[A factor analytic study of the acceptance of relaxation through Dohsa training (psychological rehabilitation training)].

This study was designed to identify factors which contribute to the acceptance of relaxation. Using the Dohsa Training technique, each of 58 female undergraduate students was given a relaxation procedure applied to the trunk and back. Following this relaxation procedure, subjects were asked to complete a 20 item questionnaire in which a five point rating scale served as an index of the degree of acceptance of relaxation. Factor analysis of the results led to identification of the following three factors: (I) psychological acceptance of the experimental situation; (II) differentiated and integrated bodily awareness; and, (III) feeling of generalized relaxation. A comparison of the factor scores of training and non-training experienced subjects revealed higher scores for the former on Factors I and II. On the other hand, non-training experienced subjects scored higher on Factor III. In addition, the difference in factor scores between concentrated and non-concentrated subjects indicated that volitional concentration on the relaxation process is indispensable for reorganizing self body-image.

Adolescent↗
PubMed2004

Accessibility and acceptability of the Department of Veteran Affairs health care: diverse veterans' perspectives.

OBJECTIVES: Diverse veteran's perspectives on the accessibility and acceptability of the Department of Veteran Affairs (VA) health services are presented. METHODS: The qualitative methodology uses 16 focus groups (N = 178) stratified by war cohort (World War II and Korean Conflict versus Vietnam War and Persian Gulf War) and four ethnic/racial categories (African American, Asian American, European American, Hispanic American). RESULTS: Five themes emerged regarding veterans' health care expectations: (1) better information regarding available services, (2) sense of deserved benefits, (3) concern about welfare stigma, (4) importance of physician attentiveness, and (5) staff respect for patients as veterans. Although veterans' ethnic/racial backgrounds differentiated their military experiences, it was the informants' veteran identity that framed what they expected of VA health services. CONCLUSIONS: Accessibility and acceptability of VA health care is related to veterans' perspectives of the nature of their entitlement to service. Provider education and customer service strategies should consider the identified factors to increase access to VA as well as improve veterans' acceptance of the care.

Aged↗
PubMed1998

Convincing cases: important component of user acceptance.

This paper is presenting the rational that lead to the organisation of the European workshop on Acceptance of Telematics Applications by Healthcare Professionals "Looking for the convincing cases," that took place in Thesaloniki 12-13 December, 1997. A brief overview is presented of the health telematics sector, the current situation of the usage of some applications, and major challenges towards wide implementation of health telematics applications. It focuses on user acceptance as one of the critical challenges towards wider implementation. It concludes that the support and promotion "Convincing cases" are important components contributing to user acceptance.

Attitude of Health Personnel↗
PubMed1999

[Acceptance and long-term results of home mechanical ventilation in various thoracic diseases].

BACKGROUND: Home mechanical ventilation (HMV) is an important therapy for patients with respiratory insufficiency on the basis of neuromuscular diseases (NMD), chest wall deformities (CWD) and chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: We retrospectively analyzed the long-term results of all 144 patients (CWD = 47, COPD = 54, NMD = 43) who underwent a trial of non-invasive HMV from March 1990 to September 1997. RESULTS: Twenty-eight patients did not accept the HMV (19%), 7 with CWD (15%), 17 with COPD (32%) and 4 with NMD (9%). Thirty-nine of 113 patients, who accepted HMV, completed nasal ventilation for a minimum of 1 year. For all 3 groups the hypercapnia improved significantly (CWD 58 +/- 6 to 48 +/- 4 mm Hg, p < 0.001, COPD 61 +/- 7 to 46 +/- 6 mm Hg, p < 0.001, NMD 53 +/- 8 to 42 +/- 6 mm Hg, p < 0.001). CONCLUSION: HMV improves the hypercapnic ventilatory failure independent of the underlying disease. The rate of acceptance is lower in patients with COPD in comparison to CWD and NMD.

Home Nursing↗
PubMedDate not supplied

[Acceptance and use of medicinal plants in family medicine].

OBJECTIVE: To explore the degree of usage of therapeutic medical plants among the patients, physicians and health workers in a local Family Medical Care Unit of the Mexican Institute of Social Security (IMSS)). MATERIAL AND METHODS: A transversal descriptive study was performed. A questionnaire focusing on two variables was designed and validated. It was applied to 60 family physicians, a randomized sample of 130 health workers and another of 264 patients of the Family Mediccal Care Unit. Response percentage was 78%. RESULTS: The study found that 83% of family physicians accept the therapeutic use of herbal medicine; moreover, 75% use it as a therapeutic resource. Among health workers, acceptance and use was 100%, while in patients the level of acceptance was of 92% and of use it was 90%. Differences between groups are significant (p < 0.05). The more frequently used plants are Gordolobo (Gnaphalium sp.), Eucalyptus (Eucalyptus sp., probably E. globulus), spearmint (Mentha sp.), camomile (Matricaria chamomilla) and prickly pear cladodes (the vegetative parts of the prickly pear, Opuntia sp. Probably Opuntia ficus indica). CONCLUSIONS: This information agrees with previous reports about Mexico, however, in this case, data were gathered in urban areas where physicians have been trained in the biomedical paradigm of medicine.

Cross-Sectional Studies↗
PubMed1999

Providing immunizations in a pediatric emergency department: underimmunization rates and parental acceptance.

OBJECTIVES: To assess the vaccination status and vaccinate eligible children with age-appropriate antigens. DESIGN: Intervention. SETTING: Pediatric emergency department in an urban, public hospital. PATIENTS: Convenience sample of children, aged birth through 72 months. INTERVENTIONS: Immunization of eligible children. MAIN OUTCOME MEASURES: 1) Immunization coverage rates in the sample population, 2) Acceptance rates of immunization. RESULTS: A total of 9321 children were enrolled over a 2-year period. Fifty-nine percent were documented to be underimmunized. Overall, 2514 children received a total of 6482 immunizations. Parents who carried portable immunization cards documenting that their child was underimmunized were almost five times more likely to accept immunization for their child than parents who lacked documentation (71% vs 15%, P < 0.0001). The estimated cost of providing immunizations in the emergency department was $47.15 per child immunized, or $18.56 per immunization given. CONCLUSIONS: The majority of children with documentation of immunization status were underimmunized. When documentation of underimmunization was available, parents were significantly more likely to accept vaccination. These data suggest that vaccinating children in nontraditional settings is feasible and support the creation of an accessible vaccine registry.

Child↗
PubMed2001

Effect on compliance, acceptability of blood glucose self-monitoring and HbA(1c) of a self-monitoring system developed according to patient's wishes. The ACCORD study.

OBJECTIVES: To test a blood glucose monitor developed upon diabetic's recommendations (Glucotrend Premium). Self-monitoring of blood glucose (SMBG) generates hope when introduced, however several studies questioned its efficacy and many diabetics judge it too constraining. MATERIAL AND METHODS: Thirty diabetes centres in France, for 6 months in 179 insulin-treated diabetics, using SMBG but non optimally and with HbA(1c) (>=130% of the upper limit). Randomisation to 3 groups: either their previous system (Group A), or to the Glucotrend Premium monitor with a memory to assess compliance (Group B), or to another monitor, new for the patient, and with a memory too, the One Touch Profile (Group C). At entry, and then at 3 and 6 months, patients had an acceptability and compliance questionnaire, HbA(1c), count of weekly hypoglycaemia, record of insulin doses and an assessment of the key compliance factors. RESULTS: HbA(1c) improved significantly in the 3 groups, more markedly in groups B (Glucotrend) and C (One Touch), e.g. - 0.6 +/- 1.1% (group A), - 0.9 +/- 1.2% (group B) and - 1.0 +/- 0.9% (group C) at M6. Acceptability was judged better for groups B and C, an additional benefit for Glucotrend: better accuracy vs laboratory blood glucose (C/L) determinations and a lower utilisation cost. Intermediate (lente) and regular insulin doses only significantly decreased (26% and 10% respectively) in group B (Glucotrend) despite a decrease in HbA(1c). Compliance (defined as 75-150% of recommended self-monitoring) improved within the 3 groups (from 34% to 65%), this improvement was maintained after month 3 (M6: 76%) only in group B (Glucotrend), vs a worsening in groups A and C (M6: 62 and 57% respectively). A better accuracy of C/L was observed with Glucotrend at M0, M3 and M6. CONCLUSION: SMBG has limits due to various causes, and to specific difficulties of this invasive and repetitive technique. The development of a system based on advices formulated by patients themselves, Glucotrend Premium, has resulted in a marked improvement on acceptability, compliance and glucose control.

Adult↗
PubMed2001

Universal patient acceptance: ethics pipe dream or key to improved access in dentistry?

The authors discuss ways that dentistry engages silently and sometimes unknowingly in practice patterns that adversely affect public access to dental care. The concept of acceptance is explained and contrasted with treatment and with access to care. The concept of Universal Patient Acceptance (UPA) is introduced, with a focus on how it underlies and precedes access, creating a pathway so that truer universal access to dental care can be realized. The authors argue that a commitment to Universal Patient Acceptance shows promise as an important starting point in the dental profession's concern to address society's unmet oral health needs.

Delivery of Health Care↗
PubMed2002

Predictors of influenza vaccine. Acceptance among healthy adult workers.

A self administered questionnaire with items derived from the Health Belief Model was mailed to a random sample of workers prior to a worksite influenza vaccine program in this descriptive study of 207 service and clerical workers. The researchers investigated the utility of the Health Belief Model in predicting influenza vaccine acceptance. A second postcard questionnaire was mailed after the program to verify the vaccination status. Workers who received the vaccine had higher scores for susceptibility, seriousness, benefits, cues to action, knowledge, and health motivation and lower scores for barriers than did workers who did not receive a vaccine. Logistic regression analysis revealed the importance of benefits, barriers, and cues to action in predicting influenza vaccine acceptance. Study results suggest education and program efforts directed toward increasing benefits, dispelling myths about influenza and the vaccine, reducing barriers, and developing a campaign to increase program awareness may increase workers' vaccine acceptance.

Attitude to Health↗