bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life in Cancer Patients
Authors: McMillan Susan C. , Weitzner Michael 
Published: March 2003

PURPOSE
: Improving or maintaining the quality of life for persons with cancer is a major goal of end‐of‐life care; however, to measure quality‐of‐life outcomes, a valid and reliable measure is needed. The purpose of this project was to report the psychometric properties of the revised Hospice Quality of Life Index (HQLI), including validity and reliability for hospice patients with cancer.
DESCRIPTION
: Data were collected from home care hospice patients with cancer (n = 255) and a group of apparently healthy adults in the community (n = 32). The revised HQLI is a 28‐item self‐report instrument that includes three subscales: Psychophysiological Well‐being, Functional Well‐being, and Social/Spiritual Well‐being.
RESULTS
: Evidence for validity was provided in three ways. First, factor analysis confirmed the three subscales (Psychophysiological, Functional, and Social/Spiritual Well‐being). Second, a weak significant correlation was found between the Easterm Cooperative Oncology Group Performance Status Rating scores and HQLI scores (r= .26; P= .00). Third, the HQLI was able to discriminate between hospice patients with cancer and apparently healthy adults (λ= .34; P= .00). In addition, the mean scores of these two groups were significantly different (t= 6.64; P= .00). However, only a minimal difference in scores was found on the Social/Spiritual Well‐being subscale between the cancer and healthy groups. Reliability for the revised HQLI was high for both the total scale (α= .88) and the subscales (α =.82–.85).
CLINICAL IMPLICATIONS
: Emphasis has been placed recently on understanding quality of life from the patient's perspective. The development of a valid and reliable tool can guide care givers in providing meaningful quality‐of‐life care. The HQLI provides patients the opportunity to express beliefs about quality‐of‐life issues and to maintain direction over a critical aspect of their care. Of note from this study, the significant difference between groups in functional well‐being and minimal difference in social/spiritual well‐being suggest that patients are able to appraise their functional abilities realistically and still maintain their social network and spiritual beliefs. Indeed, it may be that patients give family relationships and spiritual beliefs greater focus during a terminal illness.
The Role of the Physician as an Information Source on Mammography
Authors: Metsch Lisa R. , McCoy Clyde B. , McCoy H. Virginia , Pereyra Margaret , Trapido Edward , Miles Christine 
Published: March 2003

purpose
: The value of mammography for asymptomatic women younger than 50 years of age has been under debate, and it had been suggested that each woman should decide for herself whether to start having mammograms in her 40s. This decision‐making process requires women to have knowledge of screening guidelines. This study reported key determining informational factors that led women age 40 and older to obtain a mammogram.
description of study
: To examine the relationship between sources of information and utilization of mammography, the authors conducted a communitywide telephone survey, in English and Spanish, of a stratified random sample of 999 white, black, and Hispanic women in Dade County, Florida. The survey was designed to measure knowledge, attitudes, practices, and beliefs about breast cancer, its prevention, and its early detection. Data for 784 women 40 years and older are analyzed and reported here.
results
: The most commonly cited source of information was the media (90.2%). In a logistic regression, having had a checkup in the past year was the strongest predictor of having had a recent mammogram as opposed to a distant one (OR 4.17; 95% CI 2.92–5.95). Women who named their physician as an important source of information about health and prevention were also more likely to have had a recent examination (OR 1.85; 95% CI 1.27–2.69).
clinical implications
: This analysis of the relationship between the source of information and utilization of mammography suggests that physicians, as sources of information, serve to motivate women to obtain a mammogram. This is true even after taking into account the patient's age and utilization of the healthcare system for preventive care in general. For this reason, it is imperative that clinicians be aware of national guidelines for breast cancer screening; of the risks and benefits of screening measures; and of the implications of a positive and negative test result. In addition, clinicians must realize the importance of follow‐up to remind the patient to obtain a mammogram or other screening test and should develop strategies to provide this service.
The Impact of Radiation Therapy on Quality of Life in Patients withCancer
Authors: Liu Li , Meers Kathy , Capurso Anita , Engebretson Tilmer O. , Glicksman Arvin S. 
Published: March 2003

purpose
: This study was conducted to evaluate the physical and mental status change during and after a course of radiation treatment in patients with cancer.
description of study
: Twenty‐four patients with various malignant diseases were enrolled, including 9 men and 15 women, whose median age was 64.5, to receive radiation therapy. All patients also received psychosocial support from nurses, social workers, and/or organized support groups. The Rand 36‐item survey 1.0 (SF‐36) was completed at the beginning, the second week, the completion of treatment, and 1 and 3 months after treatment for the evaluation of physical component scores and mental component scores. Karnofsky performance scale and toxicity scores were determined by the treating nurses and physicians.
results
: The physical component scores of evaluated patients before treatment were approximately 20% lower than those of the general U.S. population, whereas mental component scores were similar to those of the general U.S. population. After treatment started, Karnofsky performance scale decreased concurrently with an increased rate of toxicity. Both physical and mental component scores were relatively stable throughout the course of evaluation. Mental component scores were the only predictor of toxicity during the treatment. Karnofsky performance scale dropped to their lowest point at the completion of treatment and then improved at 1‐month follow‐up.
clinical implications
: The patients who had higher mental component scores before treatment appeared to have higher, and improving, physical component scores throughout the course of evaluation. Along with complementary social support, the implementation of psychosocial support early and throughout the course of treatment may result in physical benefits and improving overall quality of life. Care should also be taken to make psychosocial support available to patients after the completion of treatment.
Presurgery Experiences of Prostate Cancer Patients and Their Spouses
Authors: Gray Ross E. , Fitch Margaret I. , Phillips Catherine , Labrecque Manon , Klotz Laurence 
Published: March 2003

purpose
: In this article, the authors describe the experiences of men with prostate cancer and their spouses between diagnosis and surgery.
description
: As part of a longitudinal qualitative study, semistructured interviews were held with 34 prostate cancer patients who were waiting for surgery. Separate interviews were held with their spouses.
results
: Six main components of experience were evident from the analysis of transcripts related to the presurgery period: 1) the news of a diagnosis of prostate cancer came initially as a shock for both partners, the impact of which lessened over time; 2) the new reality of illness necessitated readdressing the marital relationship, most often resulting in a sense of renewed connection and commitment; 3) the illness crisis precipitated a search for information to guide decisions about treatment; 4) there was a need for couples to decide who to inform about the cancer diagnosis and how much to say about it; 5) couples attempted to seek a semblance of normality in their lives, especially after treatment decisions had been made; and 6) despite attempts to minimize the potential impact of upcoming surgery, anxiety was typically experienced at least intermittently by one or both partners.
clinical implications
: Physicians, nurses, social workers, and other health professionals need to facilitate attempts by the patient to gather and synthesize information. Cancer specialists can play a positive role in reducing distress in couples, and, thus, the attention of the specialists to communication issues is critical. The strain of waiting for surgery must be considered when treatment recommendations are made; watchful waiting protocols require further study from a psychological perspective. Clinicians need to be alert to the balance between being positive and carrying on as normal, and acknowledging and dealing with the distress that arises.
Healing Icons: Art Support Program for Patients with Cancer
Authors: Heiney Sue P. , Darr‐Hope Heidi 
Published: March 2003

objectives: The purpose of this report is to describe the structure and process of an art support program for patients with cancer who are age 16 and older.materials and methods: Healing Icons is a six‐session art support program for cancer patients. During the program participants create a three‐dimensional mixed‐media art piece to convey a unique personal perspective on receiving a diagnosis of and being treated for cancer. Concurrently, the patients spontaneously share common experiences about their cancer, which leads to strong emotional bonds. The purpose and goals of the program, method of implementation, and evaluation are described. Information and suggestions that clinicians might find useful in developing similar programs are discussed. Patient participants, their families, and staff in the cancer center have reported positive clinical evaluations.conclusions: The benefits of Healing Icons are derived from the therapeutic factors present in a traditional support group blended with the creative process. This kind of program opens new avenues for expressing feelings and thoughts but should be structured in such a way that group processes are not allowed to negatively impact participants. Healthcare professionals interested in collaborating with artists on similar programs for cancer patients may approach artists through local art councils, art schools, and artists guilds. Brainstorming sessions with artists would help to capitalize on the expertise of artists within the community. Initiating a pilot project would help gauge patient interest and would provide valuable feedback from the healthcare team. Research is needed to validate the clinical outcomes derived from this program, as empirical findings would greatly enhance the clinical evaluations.
Veiled Yet Vulnerable
Authors: Millon Underwood Sandra , Shaikha Lubna , Bakr Dhiya 
Published: March 2003

objectives: While multiple reports have been published in the literature that describe the effect of religion and spirituality on healthcare practices, few have been reported that attempt to describe the effect of the fundamental beliefs and customs of the followers of Islam. A qualitative study aimed toward gaining an understanding of the degree to which Islamic beliefs and customs influence followers' breast cancer screening practices was, therefore, undertaken.materials and methods: The study was designed with semistructured focus groups as the primary means of gathering data. A purposefully selected sample of nine Muslim women were recruited to participate in the study. Throughout the focus group, attempts were made to engage the women in a manner that stimulated in‐depth discussion of the beliefs and customs influencing breast cancer screening.results: Data revealed that the religious beliefs and customs of the Muslim women participating in the focus group significantly influenced their participation in breast cancer screening. Despite their knowledge of the benefits of regular breast cancer screening, the women indicated that they choose not to participate in available breast cancer screening programs, given that they were not structured in a manner that was consistent with the beliefs and customs of Islam.conclusions: This study illustrates the manner and degree to which Islamic beliefs and customs can influence the breast cancer screening behavior of Muslim women and the importance of carefully designing breast health programs tailored to the needs of this population of women.
Daily Fatigue Patterns and Effect of Exercise in Women with Breast Cancer
Authors: Schwartz Anna L. 
Published: March 2003

Objectives: Cancer treatment‐related fatigue is a common and disruptive side effect of chemotherapy. Exercise is an intervention proposed to reduce fatigue in cancer patients. The purpose of this study was to describe the patterns of daily fatigue in women with breast cancer who did and did not exercise while receiving the first three cycles of adjuvant chemotherapy.Materials and methods: Women received instruction to follow an 8‐week home‐based exercise program and to maintain daily exercise and fatigue diaries. Functional ability (12‐minute walk) was measured pretest and post‐test.Results: Several distinct patterns of fatigue emerged. The most common pattern of fatigue after chemotherapy demonstrated a sharp rise in fatigue. However, several women demonstrated a chaotic pattern with erratic and wide swings in their fatigue throughout the entire study period. Women who adopted exercise experienced fewer days of high fatigue levels and more days of low levels of fatigue for both average and worst levels of fatigue. Women who did not exercise experienced more bad days (high fatigue) and fewer good days (low fatigue).Conclusions: Exercise appears to reduce the levels of average and worst fatigue and may help women recognize their pattern of fatigue. Exercise may reduce the intensity of fatigue by reorganizing women's interpretation of fatigue. Routine clinical assessment and education about fatigue by health professionals can help patients to understand their pattern of fatigue and may help them to manage the symptom.
The Sexual Rehabilitation of Persons with Cancer
Authors: Gallo‐Silver Les 
Published: March 2003

Objectives: This article presents cognitive and behavioral sexual rehabilitation interventions to assist persons with cancer in understanding and adjusting to the physical changes caused by cancer treatment.Materials and methods: Interventions described here include educating patients about the phases of sexual functioning and the impact of treatment, giving patients permission to explore their ability to respond to sexual stimulation by using self‐pleasuring exercises, teaching sensate focus exercises that structure noncoital foreplay; and suggesting changes in coital positions.Results: Sexual functioning is an important aspect of quality of life for people with cancer that continues to be difficult for oncology professionals to address. Familiarity with these interventions can prepare the properly trained oncology social workers, nurses, and other mental health professionals to assist cancer patients with their concerns about sexual functioning.Conclusions: All oncology professionals should be aware of the importance of recognizing and addressing issues of sexual functioning in patients with cancer to validate the patient's experience and make the proper referral to a trained sex therapist.
Smoking Behavior, Knowledge, and Beliefs Among Korean Americans
Authors: Kim Katherine K. , Yu Elena S.H. , Chen Edwin H. , Kim JaeKyung , Brintnall RuthAnn , Vance Simon 
Published: March 2003

Purpose: The purpose of the study was to examine smoking behavior, knowledge, and beliefs among Korean Americans.description of Study: One hundred four Korean American men and 159 women, 40 to 69 years old, living in Chicago, Illinois, served as study respondents. The National Health Interview Survey (NHIS) Cancer Control Supplement Questionnaire was used to collect data. The NHIS was translated into Korean with minor modifications to develop a culturally appropriate instrument.Results: This study suggests that smoking is almost exclusively a male behavior (38.5%) and that Korean American men smoke mostly cigarettes. Almost 90% of women have never smoked, whereas 23% of men reported never smoking. Respondents with a non‐Christian background or no religious affiliation were 16.5 times more likely to be current smokers. Respondents who had lived in the United States less than 10 years were 12.5 times more likely to be current smokers. More than 90% of men, regardless of smoking status, were able to identify an association between smoking and major chronic diseases.clinical Implications: The prevalence of smoking among these Korean American men places them at considerable risk for smoking‐related disease. Healthcare providers must be better informed about smoking behavior in this group, and specific attention to recently migrated men and those reporting religions other than Christianity is recommended. Health‐protecting strategies for women and children who fall victim to secondhand smoke, or who may be targeted by tobacco advertising, are also an important step in disease prevention for this population.
Fatigue and Quality of Life Outcomes of Exercise During Cancer Treatment
Authors: Mock Victoria , Pickett Mary , Ropka Mary E. , Lin Esther Muscari , Stewart Kerry J. , Rhodes Verna A. , McDaniel Roxanne , Grimm Patricia M. , Krumm Sharon , McCorkle Ruth 
Published: March 2003

Purpose: Despite the recognition of fatigue as a common and distressing symptom during cancer treatment, there are few evidence‐based interventions available to manage such fatigue. The purpose of this multi‐institutional pilot study was to explore the effects of a home‐based moderate walking exercise intervention on fatigue, physical functioning, emotional distress, and quality of life (QOL) during breast cancer treatment.Description of study: Fifty‐two women were recruited from five university hospital outpatient departments for this pilot study with an experimental design. Subjects were randomly assigned to the walking program or to usual care during adjuvant chemotherapy or radiation therapy for breast cancer. Symptoms, physical functioning, and QOL were measured at baseline, midtreatment, and at the end of treatment.Results: Women who exercised at least 90 minutes per week on 3 or more days reported significantly less fatigue and emotional distress as well as higher functional ability and QOL than women who were less active during treatment.Clinical implications: A home‐based walking exercise program is a potentially effective, low‐cost, and safe intervention to manage fatigue and to improve QOL during adjuvant chemotherapy or radiation therapy for breast cancer. This health‐promoting self‐care activity needs further testing in large randomized clinical trials.
Supports and Obstacles to Cancer Survival for Hawaii's Native People
Authors: Braun Kathryn L. , Mokuau Noreen , Hunt G. Haunani , Kaanoi Momi , Gotay Carolyn C. 
Published: March 2003

purpose: Investigators have suggested that high cancer mortality rates among Native Hawaiians are due to fatalistic attitudes toward the disease, poor access to care, and lack of consideration of Native Hawaiian cultural values in Western approaches to healthcare. This study used qualitative methods to examine these factors in Native Hawaiian cancer survivors.methods: Eight focus groups were held on five islands, attracting 45 Native Hawaiian cancer survivors from both rural and urban locales. The focus groups explored survivors' experiences with cancer diagnosis, treatment, and recovery. Participatory research methods were used, with researchers gaining community input on study design, incorporating appropriate Native Hawaiian cultural protocols into the focus groups, and engaging participants in the interpretation of the data.results: Similar to cancer survivors of other ethnicities, these individuals demonstrated the following: success in accessing healthcare information, professionals, facilities, and insurance; the ability to overcome the barriers confronted; and proactive health behaviors regarding screening, diagnosis, and treatment. They also demonstrated ways in which they were sustained through the cancer experience by Native Hawaiian traditions, such as helping others, gaining strength from Hawaiian spiritual beliefs, and relying on family for personal support. Participants did not respond passively to their cancer diagnoses, and they expressed few fatalistic attitudes. Participants did give numerous examples of other Native Hawaiians who did not seek screening or treatment for cancer because they lacked insurance, had poor access to care, or felt alienated by Western healthcare.clinical implications: The findings suggest that improving access to care and incorporating cultural values in health education and services can enhance survivorship and quality of life for Native Hawaiians with cancer. These themes may have applications for other minority groups.
Evaluating Post‐Treatment Screening in Women with Breast Cancer
Authors: Stark Azadeh , Prince Angela , Kucera Gena , Lu Mei , Raju Usha , Nathanson David 
Published: March 2003

purpose: The objective of this study was to evaluate the 5‐year post‐treatment use rate for screening mammography and clinical breast examination (CBE) among women treated for atypical hyperplasia (AH) or carcinoma in situ (CIS).description of study: A total of 103 women, who had received diagnoses and had been treated for primary AH or CIS, were observed for 5 years through a review of medical records and electronic databases. Adequate screening use was defined as the patient undergoing one mammography examination and at least one CBE per year.results: Multivariate logistic regression showed that screening activity declined significantly with time. During the first year, 83.5% and 80.6%, respectively, of women were screened by CBE and mammography. By year 2, CBE screening had dropped by 25.2% (P < .01) and mammography screening by 9.7% (P = .08). Attrition in CBE and mammography screening continued for each consecutive year and was significant (P < .01). During the first year, 70.9% of women received both methods of screening, which declined to 9.7% by year 5. Women who had received diagnoses of CIS and those married with children were more likely to use post‐treatment screening, while fee‐for‐service insurance was negatively associated with screening.clinical implications: The reasons for the observed decline in the annual post‐treatment screening are not known. Negative findings from follow‐up screenings might have lowered the perception of cancer susceptibility and promoted the decline in screening use. A communication gap between physicians and patients might have reinforced this perception. The importance of annual screening may be verbally emphasized at each clinic visit, and reminder notes and telephone calls may be used to remind patients of upcoming screenings. Additional studies are planned to evaluate the effect of various intervention strategies in improving post‐treatment screening use.