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Lintao RCV, Cando LFT, Perias GAS, Tantengco OAG, Tabios IKB, Velayo CL, de Paz-Silava SLM. Current Status of Human Papillomavirus Infection and Cervical Cancer in the Philippines. Front Med (Lausanne) 2022; 9:929062. [PMID: 35795639 PMCID: PMC9251542 DOI: 10.3389/fmed.2022.929062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Cervical cancer is estimated to cause 341,831 deaths each year, with 9 of 10 deaths occurring in developing countries. Over the past decade, there has been a significant increase in cervical cancer incidence among women in the Philippines. Persistent infection with high-risk human papillomavirus (HPV) is the well-established necessary cause of cervical cancer. Based on limited studies conducted in the Philippines, the prevalence of infection with any HPV genotype was 93.8% for cervical squamous cell carcinoma and 90.9% for cervical adenocarcinomas. HPV types 16 and 18 were the most common HPV genotypes among Filipino patients with cervical cancer. On the other hand, the incidence of HPV infection among Filipino women with normal cervices was 9.2%. The World Health Organization has launched a global agenda of eliminating HPV infection by 2030. One of its key milestones is to vaccinate 90% of girls with the HPV vaccine by 15 years. However, the HPV vaccination rate among Filipino women remains to be unsatisfactory. HPV vaccination has only been included in the Philippine Department of Health's community-based National Immunization Program in 2015. Despite these efforts, the Philippines currently ranks last on HPV program coverage among low-middle income countries, with coverage of only 23% of the target female population for the first dose and 5% for the final dose. The principal reason for the non-acceptance of HPV vaccines was the perceived high cost of vaccination. The low utilization of available cervical cancer screening tests such as Pap smear and visual inspection with acetic acid hampered the Philippines' control and prevention of HPV infection and cervical cancer. Among those diagnosed with cervical cancer in the Philippines, only an estimated 50% to 60% receive some form of treatment. To this end, we summarize the burden of HPV infection and cervical cancer on Filipinos and the risk factors associated with the disease. We present the current screening, diagnostics, treatment, and prevention of HPV-related diseases in the Philippines. Lastly, we also propose solutions on how each building block in health systems can be improved to eliminate HPV infection and reduce the burden of cervical cancer in the Philippines.
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Affiliation(s)
- Ryan C. V. Lintao
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Leslie Faye T. Cando
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Glenmarie Angelica S. Perias
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Ourlad Alzeus G. Tantengco
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Ian Kim B. Tabios
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City, Philippines
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Clarissa L. Velayo
- Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Sheriah Laine M. de Paz-Silava
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Department of Medical Microbiology, College of Public Health, University of the Philippines Manila, Manila, Philippines
- *Correspondence: Sheriah Laine M. de Paz-Silava
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2
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Feng GC, Zhu S, Zhao X. Antecedents and Consequences of Smoking Cessation Intention in the Context of the Global COVID-19 Infodemic. Front Public Health 2021; 9:684683. [PMID: 34497791 PMCID: PMC8419308 DOI: 10.3389/fpubh.2021.684683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
A growing body of scientific studies has been published to inform responses to the ongoing coronavirus pandemic, and some have claimed that cigarette smoking has a beneficial or mixed effect on the prevention and treatment of COVID-19. The presentation of such findings, unfortunately, has created an infodemic. This study integrated the theory of planned behavior and the health belief model and incorporated findings on addiction from the medical literature to predict cessation intention and support for tobacco control measures in the context of the COVID-19 infodemic. The study found that cessation intention partially mediated the effect of perceived severity and fully mediated the effects of perceived benefits, self-efficacy, and addiction on support for control measures. In addition, a positively-valenced message of the effect of smoking on the prevention and treatment of COVID-19 vs. a mixedly-valenced message was significant in predicting cessation intention, and the positively-valenced message of smoking indirectly predicted support for tobacco control measures. Perceived susceptibility, barriers, and subjective norms, however, exerted neither direct nor indirect effects on the two outcome variables.
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Affiliation(s)
| | - Shan Zhu
- College of Communication, Shenzhen University, Shenzhen, China
| | - Xinshu Zhao
- Department of Communication, University of Macau, Macau, China
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3
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Hyner GC, Melby CL, Petosa R, Seehafer R, Black DR. A Preferred Target Population for Comprehensive Health Promotion. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2016; 8:249-61. [DOI: 10.2190/cfjq-c2n5-1dcd-ll02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Health promotion (HP) strategies have been advocated as a means of enhancing individual responsibility for health maintenance, while reducing client dependence on the medical care system. Similarly, advocates of HP have suggested that it may positively affect medical costs and physical/behavioral risk factors among others. To properly test the long-term effects of carefully planned HP interventions, a preferred target population is proposed. It is suggested that clientele would be drawn from moderate or low risk individuals who are seldom the population-of-interest within the traditional medical care model. The authors offer a model for comprehensive HP and discuss the implications of defining a target population for HP strategies.
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Affiliation(s)
| | | | - Richard Petosa
- Department of Health Promotion, University of South Carolina, Columbia
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4
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Purkabiri K, Steppacher V, Bernardy K, Karl N, Vedder V, Borgmann M, Rogausch A, Stammberger U, Bals R, Raupach T, Koellner V, Hamacher J. Outcome of a four-hour smoking cessation counselling workshop for medical students. Tob Induc Dis 2016; 14:37. [PMID: 27924139 PMCID: PMC5123240 DOI: 10.1186/s12971-016-0103-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 11/18/2016] [Indexed: 11/25/2022] Open
Abstract
Background Lack of smoking cessation education in undergraduate medical training hinders healthcare professionals in providing adequate tobacco cessation counselling. We developed a comprehensive 4-h smoking cessation counselling course for medical students that is easy to incorporate in a medical school curriculum, and assessed its short-term outcome for knowledge, skills, and attitudes. Methods Eighty-eight medical students (53f, 35 m) were educated by a doctoral student in five identical 4-h courses. A 45-min theoretical introduction was followed by patient-physician role-playing by student pairs. Knowledge, skills, and attitude were assessed before and 4 weeks after the course by questionnaires, and by blinded analysis of pre- and post-course videos of a five-minute standardized patient situation. Results Knowledge: Before the course 10.6 (mean, SD: 2.7) questions out of 29 were answered correctly, and increased to 19.2 (3.6) after the course (p < 0.0005). Major features of the students’ counselling skills improved. Significant and highly relevant attitude changes reflected increased motivation to counselling smokers. Conclusion Implementing a four-hour smoking intervention workshop into a medical curriculum was highly effective in improving students’ knowledge, skills and attitudes towards smoking counselling, as well as providing them with additional clinical competencies. Electronic supplementary material The online version of this article (doi:10.1186/s12971-016-0103-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kurosch Purkabiri
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany.,Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
| | - Valentina Steppacher
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany
| | - Kathrin Bernardy
- Division of Pain Medicine, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil GmbH, Bochum, Germany
| | - Nikola Karl
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany.,Divison of Internal Medicine, Hospital of Münsingen, Münsingen, Switzerland
| | - Verena Vedder
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany.,University Hospital of Psychiatry, Bern, Switzerland
| | - Michèle Borgmann
- Clinic of Internal Medicine, Lindenhofspital, Bremgartenstrasse 119, CH-3012 Bern, Switzerland
| | - Anja Rogausch
- Clinic Sonnenhalde, Riehen, Switzerland.,Division of Assessment und Evaluation, Institute for Medical Teaching, University of Bern, Bern, Switzerland
| | - Uz Stammberger
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany
| | - Robert Bals
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany
| | - Tobias Raupach
- Department of Cardiology and Pneumology, University Hospital Göttingen, Göttingen, Germany
| | - Volker Koellner
- Department of Behavioral Therapy and Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency, Teltow, Germany.,Medical Faculty, Saarland University Hospitals, Homburg/Saar, Germany
| | - Jürg Hamacher
- Division of Pulmonary Medicine, Internal Medicine, University Hospitals of Homburg/ Saar, Saarland University, Homburg/Saar, Germany.,Clinic of Internal Medicine, Lindenhofspital, Bremgartenstrasse 119, CH-3012 Bern, Switzerland
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5
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Fu SS, Sherman SE, Yano EM, van Ryn M, Lanto AB, Joseph AM. Ethnic Disparities in the Use of Nicotine Replacement Therapy for Smoking Cessation in an Equal Access Health Care System. Am J Health Promot 2016; 20:108-16. [PMID: 16295702 DOI: 10.4278/0890-1171-20.2.108] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. To examine ethnic variations in the use of nicotine replacement therapy (NRT) in an equal access health care system. Design. Cross-sectional survey. Setting. Eighteen Veterans Affairs medical and ambulatory care centers. Subjects. A cohort of male current smokers (n = 1606). Measures. Use of NRT (nicotine patch or nicotine gum), ethnicity, sociodemographics, health status, smoking-related history, and facility prescribing policy. Results. Overall, only 34% of African-American and 26% of Hispanic smokers have ever used NRT as a cessation aid compared with 50% of white smokers. In the past year, African-American smokers were most likely to have attempted quitting. During a serious past-year quit attempt, however, African-American and Hispanic smokers reported lower rates of NRT use than white smokers (20% vs. 22% vs. 34%, respectively, p = .001). In multivariate analyses, ethnicity was independently associated with NRT use during a past-year quit attempt. Compared with white smokers, African-American (adjusted odds ratio, .53; 95% confidence interval, .34–.83) and Hispanic (adjusted odds ratio, .55; 95% confidence interval, .28–1.08) smokers were less likely to use NRT. Conclusions. Assessment of variations in use of NRT demonstrates that African-American and Hispanic smokers are less likely to use NRT during quit attempts. Future research is needed on the relative contributions of patient, physician, and system features to gaps in guideline implementation to provide treatment for ethnic minority smokers.
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Affiliation(s)
- Steven S Fu
- Section of General Internal Medicine, Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417, USA.
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6
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Geltman PL, Adams JH, Cochran J, Doros G, Rybin D, Henshaw M, Barnes LL, Paasche-Orlow M. The impact of functional health literacy and acculturation on the oral health status of Somali refugees living in Massachusetts. Am J Public Health 2013; 103:1516-23. [PMID: 23327248 DOI: 10.2105/ajph.2012.300885] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed the impact of health literacy and acculturation on oral health status of Somali refugees in Massachusetts. METHODS Between December 2009 and June 2011, we surveyed 439 adult Somalis who had lived in the United States 10 years or less. Assessments included oral examinations with decayed, missing, and filled teeth (DMFT) counts and measurement of spoken English and health literacy. We tested associations with generalized linear regression models. RESULTS Participants had means of 1.4 decayed, 2.8 missing, and 1.3 filled teeth. Among participants who had been in the United States 0 to 4 years, lower health literacy scores correlated with lower DMFT (rate ratio [RR] = 0.78; P = .016). Among participants who had been in the country 5 to 10 years, lower literacy scores correlated with higher DMFT (RR = 1.37; P = .012). Literacy was not significantly associated with decayed teeth. Lower literacy scores correlated marginally with lower risk of periodontal disease (odds ratio = 0.22; P = .047). CONCLUSIONS Worsening oral health of Somali refugees over time may be linked to less access to preventive care and less utilization of beneficial oral hygiene practices.
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Affiliation(s)
- Paul L Geltman
- Refugee and Immigrant Health Program, Massachusetts Department of Public Health, 300 South Street, Jamaica Plain, MA 02130, USA.
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7
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Nicklett EJ, Liang J. Diabetes-related support, regimen adherence, and health decline among older adults. J Gerontol B Psychol Sci Soc Sci 2009; 65B:390-9. [PMID: 19541672 DOI: 10.1093/geronb/gbp050] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED OBJECTIVES. Social support is generally conceptualized as health promoting; however, there is little consensus regarding the mechanisms through which support is protective. Illness support has been proposed to promote regimen adherence and subsequent prevention of health decline. We hypothesize that (a) support for regimen adherence is negatively associated with self-reported health decline among older diabetic adults and that (b) regimen adherence is negatively associated with health decline among older diabetic adults. METHODS We used the Health and Retirement Study data on individuals over the age of 60 years with type 2 diabetes mellitus (n = 1,788), examining change in self-reported health status over a 2-year period using binomial and cumulative ordinal logistic regression models. RESULTS Diabetic support is not significantly associated with health decline, but it is strongly associated with adherence to health-promoting activities consisting of a diabetic regimen. Therefore, the extent to which one receives illness support for a given regimen component is highly positively associated with adhering to that component, although this adherence does not necessarily translate into protection against perceived decline in health. CONCLUSIONS Illness-related support appears to be a mechanism through which social support matters in the diabetic population. Although this relationship did not extend to prevention of health status decline among diabetics, the relationship between support and illness management is promising.
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Affiliation(s)
- Emily J Nicklett
- Department of Health Management and Policy, School of Public Health, University of Michigan, 109 South Observatory Street, SPH 2, Ann Arbor, MI 49109-2029, USA.
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8
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Abstract
Healthcare providers' ability to motivate people to try to quit smoking or to remain abstinent is limited. Even with our best treatments, most smokers relapse within 1 year. Therefore it is important that we constantly strive to develop and test new, effective smoking interventions. Providing feedback on one's biomarkers (e.g., biological indices of smoking-related harm, harm exposure, or genetic susceptibility to disease) have been suggested as potentially useful for increasing smokers' motivation or ability to quit smoking. In fact, variations of this strategy are commonly incorporated into behavioral smoking-cessation interventions, but little empirical evidence has specifically addressed whether this approach is effective. In this article, the author reviews the theoretical rationale and empirical evidence regarding this practice. Although the preliminary evidence is promising, more research is needed to determine the efficacy of using biomarkers and the limits of the strategy's effectiveness. Future investigations should address these issues.
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Affiliation(s)
- J B McClure
- Center for Health Studies, Group Health Cooperative, Seattle, Washington, USA.
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9
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Abstract
As our understanding of risk factors and their interaction with individual susceptibility to disease improves, general messages designed to communicate risk seem increasingly ineffective and often misleading. Risk messages communicated through the mass media cannot convey an individual's personal susceptibility to preventable diseases or the seriousness of these diseases. The advent of new media technologies allows us to better reach the public with programs tailored to the needs and interests of individual users. Although similar in outward appearance to mass media, programs delivered through the Internet, CD-ROM, and computer kiosks offer the potential for vastly improved efficacy in communicating risk. This paper outlines the potential uses of interactive multimedia within the traditional goals of risk communication. A significant research endeavor, coupled with stronger avenues for dissemination, is recommended to achieve the potential of new media in a timely manner.
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Affiliation(s)
- V J Strecher
- University of Michigan Comprehensive Cancer Center, Health Media Research Laboratory, Ann Arbor, MI, USA
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10
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Senore C, Battista RN, Shapiro SH, Segnan N, Ponti A, Rosso S, Aimar D. Predictors of smoking cessation following physicians' counseling. Prev Med 1998; 27:412-21. [PMID: 9612831 DOI: 10.1006/pmed.1998.0286] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The purpose of this study was, to identify predictors of quitting following general practitioners' (GP) anti-smoking counseling. METHODS We studied determinants (characterized following the Precede framework) of successful quitting (1 year sustained abstinence, biochemically confirmed at 6- and 12-month follow-up) among 861 smokers randomized to the intervention groups based on repeated counseling (RC), RC + spirometric testing, and RC + nicotine gum, in a smoking cessation trial carried out in Turin, Italy. RESULTS GPs' intervention worked best for male (OR = 2.30; 95% CI, 1.13-4.52) and married (OR = 3.63; 95% CI, 1.37-9.59) smokers, for smokers who had maintained abstinence for at least 1 month in the past (OR = 6.78; 95% CI, 1.56-29.52) or at their first quit attempt (OR = 10.91; 95% CI, 2.37-50.13), and for those who spontaneously reduced their coffee consumption (OR = 3.30; 95% CI, 1.59-6.82); heavy smokers (> = 20 cig/day OR = 0.48; 95% CI, 0.24-0.93) and those living with other smokers (> = 1 smokers in the household: OR = 0.44; 95% CI, 0.22-0.90) were less likely to give up. Previous antismoking advice by the GP represented a strong barrier to success for healthy smokers (OR = 0.19; 95% CI, 0.07-0.52), but not for those reporting symptoms of shortness of breath (OR = 0.63; 95% CI, 0.39-9.20). There were no interactions between predictors and treatment conditions. CONCLUSIONS Assessment of factors influencing quitting would allow GPs to tailor their message to address existing barriers and to help patients utilize their resources for change.
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Affiliation(s)
- C Senore
- CPO Piemonte, Unitá di Epidemiologia, Turin, Italy
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11
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Kee F, McDonald P, Gaffney B. Risks and benefits of coronary angioplasty: the patients perspective: a preliminary study. Qual Health Care 1997; 6:131-9. [PMID: 10173770 PMCID: PMC1055474 DOI: 10.1136/qshc.6.3.131] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To describe what cardiac patients in Northern Ireland understand to be the benefits of coronary angioplasty and assess the extent to which they have been able to make informed choices about their treatment. DESIGN An interview based questionnaire survey completed after the patients had undergone coronary angiography, within hours of treatment counselling. SUBJECTS 150 patients consecutively recruited from two regional cardiology centres in Belfast, Northern Ireland. MAIN OUTCOME MEASURES The perceived complication rate and the perceived gain in life expectancy from coronary angioplasty. RESULTS Although most subjects had asked the consultant questions, 70% (n = 104) thought that they contributed negligibly or not at all to the treatment decision. Although 75% (n = 112) recalled discussing the complication rate from the procedure, only 27% accurately estimated this rate (as between 0.5 and 1.5%). Eighty eight per cent (n = 131) thought that their mortality risks would be substantially or greatly reduced by having the procedure. The patients anticipated a gain in life expectancy of some 10 years (median) and this was significantly in excess of the potential gain in life expectancy which dietary prudence to lower blood cholesterol, not smoking, and taking more exercise might produce (median 5 years respectively; P < 0.0001, Wilcoxon matched pairs signed rank test). CONCLUSIONS Patients vastly overrate the capacity of angioplasty to control their disease: angioplasty is seen as more effective than risk factor modification.
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Affiliation(s)
- F Kee
- Queen's University of Belfast, Northern Ireland, UK
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12
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Shuster GF, Utz SW, Merwin E. Implementation and outcomes of a community-based self-help smoking cessation program. J Community Health Nurs 1996; 13:187-98. [PMID: 8916608 DOI: 10.1207/s15327655jchn1303_6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In a time of budget constraints, health professionals are turning to minimal-contact smoking cessation programs as the most financially feasible alternative for smoking cessation. The purpose of this study was to evaluate a program by the American Lung Association using the manual Freedom From Smoking for You and Your Family (Strecher & Rimer, 1988) in a community-based smoking cessation self-help intervention. Results showed a quit rate of 15%, and study findings were consistent with other similar studies. Those most likely to succeed were over 40 years old, better educated, and among the most confident of quitting at the onset.
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Affiliation(s)
- G F Shuster
- College of Nursing, University of New Mexico, Albuquerque 87109, USA
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13
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O'Connor AM, Pennie RA. Reliability and validity of measures used to elicit health expectations, values, tradeoffs and intentions to be immunized for hepatitis B. J Clin Epidemiol 1995; 48:255-62. [PMID: 7869071 DOI: 10.1016/0895-4356(94)00102-v] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We evaluated measures eliciting health expectations, health values, health tradeoffs and intentions to take hepatitis B (HepB) vaccine among health science and technology students. We tested 23 students two weeks apart and then surveyed a cross-section of 373 students in 6 health disciplines. In a subsequent prospective study, 863 students were tested, invited to be immunized, and followed to observe who presented for immunization. The test-retest reliability coefficients exceeded 0.80 for all but the health value measures. All but the health values measures discriminated between those with strong and weak intentions to be immunized. Expectation measures discriminated among disciplines with different risks of exposure to blood and body fluids. The intention, health tradeoff and expectation measures discriminated between those who did and did not present themselves for immunization. We conclude that all but the health values measures met acceptable standards of reliability and validity. Health value tradeoff measures are more discriminating than health value measures.
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Affiliation(s)
- A M O'Connor
- University of Ottawa, Faculty of Health Sciences, School of Nursing, Ontario, Canada
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14
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Utz SW, Shuster GF, Merwin E, Williams B. A community-based smoking-cessation program: self-care behaviors and success. Public Health Nurs 1994; 11:291-9. [PMID: 7971693 DOI: 10.1111/j.1525-1446.1994.tb00190.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Given the serious health consequences of smoking, nurses need to be well-informed on how to help various client populations with smoking cessation. Much recent research is focused upon effectiveness of various programs to enhance self-efficacy and self-management skills necessary to succeed in permanent smoking cessation. This study used a model based on Orem's Self-Care Deficit Theory to examine specific variables of importance in smoking cessation using descriptors relevant to understanding self-care actions. The model is used to examine the outcomes of a community-based smoking-cessation program. Results indicate that 15% of the final sample quit smoking and 42% reduced smoking while participating in the program. Additional findings are helpful in describing actions taken by subjects who were and were not successful in quitting. Remedies suggested by the American Lung Association booklet "Freedom from Smoking for You and Your Family" were reported by subjects to be helpful in dealing with the most common problems experienced during smoking cessation. Results are applied to public health nursing, emphasizing that smoking cessation is "a process" in which individuals learn strategies that work for them.
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Affiliation(s)
- S W Utz
- University of Virginia School of Nursing, Charlottesville 22903-3395
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15
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Abstract
Although the implementation of clinical preventive services is a high priority on the national agenda and physicians acknowledge the importance of these services, implementation rates remain far below the target years after the recommendations have been released. Physicians repeatedly report that the reason for not providing preventive services is that they do not have "time." In this article, we identify attributes of the health-services system that create this phenomenon. We present evidence that formal delivery systems for preventive services must be developed if the "time" problem is to be solved, and we review why preventive-services systems need to be integrated into the current health-services system. Finally, we list the attributes that we believe a preventive-services system must have if it is to be successful. The success of clinical trials of such systems indicates that our goals of preventive services can be achieved if all persons who have an investment in clinical preventive services commit themselves to developing and supporting these systems.
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Affiliation(s)
- T E Kottke
- Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905
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16
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Des Rochers C, Dische S, Saunders MI. The problem of cigarette smoking in radiotherapy for cancer in the head and neck. Clin Oncol (R Coll Radiol) 1992; 4:214-6. [PMID: 1622882 DOI: 10.1016/s0936-6555(05)81053-2] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Smoking cigarettes during radiotherapy prolongs the period of reaction and may reduce the chance of cure. Of a group of 48 patients with advanced head and neck cancer 35 were smoking at the time of diagnosis, but 17 were persuaded to stop, although 7 relapsed later. Interviews conducted in 35 of the 48 patients revealed the problems which must be overcome if such patients are to cease smoking.
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Affiliation(s)
- C Des Rochers
- Mount Vernon Centre for Cancer Treatment, Mount Vernon Hospital, Northwood, Middlesex, UK
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17
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EVALUATING THE PATIENT WITH CORONARY ARTERY DISEASE. Nurs Clin North Am 1992. [DOI: 10.1016/s0029-6465(22)02759-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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18
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Tosteson AN, Weinstein MC, Williams LW, Goldman L. Long-term impact of smoking cessation on the incidence of coronary heart disease. Am J Public Health 1990; 80:1481-6. [PMID: 2240335 PMCID: PMC1405107 DOI: 10.2105/ajph.80.12.1481] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Using a simulation model of the US male population, we estimated the long-term impact that future smoking cessation programs would have on the distribution and occurrence of coronary heart disease in males ages 35-84. For interventions that reduce the number of smokers by 25 percent in 1990, the number of men free of coronary heart disease is projected to increase by 416,787 (0.7 percent) in 2015, and the age-standardized absolute incidence to decline by 2.3 percent. Incidence rates and absolute incidences are projected to fall in men under age 65, but absolute incidence would rise in men over age 65, in large part because of the increased number of men who were at risk for coronary heart disease because of a reduction in non-coronary smoking-related mortality. These trends were more marked for greater smoking reductions and were generally unaffected in a variety of analyses using alternative assumptions, which considered smoking as a risk factor in the elderly, a lag-time before benefits from smoking cessation were realized and secular declines in smoking prevalence. Subject to the assumptions of our model, we conclude that smoking reductions will markedly reduce coronary heart disease, especially in younger age groups, and that this benefit will be slightly offset by a small increase in absolute incidence in elderly men.
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Affiliation(s)
- A N Tosteson
- Division of Clinical Epidemiology, Brigham and Women's Hospital, Boston, MA 02115
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Wewers ME, Rachfal C, Ahijevych K. A psychometric evaluation of a visual analogue scale of craving for cigarettes. West J Nurs Res 1990; 12:672-81. [PMID: 2238644 DOI: 10.1177/019394599001200508] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M E Wewers
- Ohio State University College of Nursing, Columbus
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20
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Fiore MC, Pierce JP, Remington PL, Fiore BJ. Cigarette smoking: the clinician's role in cessation, prevention, and public health. Dis Mon 1990; 36:181-242. [PMID: 2180666 DOI: 10.1016/0011-5029(90)90007-e] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cigarette smoking is the most important preventable cause of illness and death in the United States, responsible for 390,000, or one sixth, of all deaths. Although smoking prevalence has decreased among adults, from 40% in 1965 to 29% in 1987, 49 million Americans continue to smoke. Smoking rates have declined at a slower rate among blacks, women, young people, and the less educated, groups that must be targeted for tobacco use prevention interventions. The clinician is uniquely positioned to reduce the enormous health toll from cigarette smoking. As a first step, physicians are urged to assess tobacco use during every patient visit by making smoking status a new vital sign. Although 85% of all smokers quit on their own, physicians can greatly facilitate this process. A brief intervention for physicians to help their smoking patients quit, based on a program of the National Cancer Institute, is presented. This program includes asking about smoking status during every clinic visit, advising all smoking patients to quit, assisting smokers by setting a quit date and using nicotine gum, if appropriate, and arranging follow-up with smokers who try to quit. Cessation rates of 5% to 25%, sustained for at least 1 year, are consistent with a successful, physician-mediated intervention program. Physicians are also urged to prevent smoking initiation among adolescents, particularly young girls and those not aspiring to attend college. Physicians can also reduce the enormous toll of tobacco use by acting at the public health and public policy levels. Recording tobacco use as a contributing or the underlying cause on death certificates, if appropriate, will assist in public health surveillance. Also, clinicians are urged to work at the organizational, community, and governmental levels to promote tobacco-free environments.
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Affiliation(s)
- M C Fiore
- Department of Medicine, University of Wisconsin, Madison
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21
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Conner RF, Mishra SI, Lewis MA, Bryer S, Marks J, Lai M, Clark L. Theory-based evaluation of AIDS-related knowledge, attitudes, and behavior changes. ACTA ACUST UNITED AC 1990. [DOI: 10.1002/ev.1548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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McDonald S, Haie C, Rubin P, Nelson D, Divers LD. Second malignant tumors in patients with laryngeal carcinoma: diagnosis, treatment, and prevention. Int J Radiat Oncol Biol Phys 1989; 17:457-65. [PMID: 2674074 DOI: 10.1016/0360-3016(89)90095-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Although the survival rates reported for patients with larynx carcinoma are quite good, there is a risk of developing second malignant tumors (SMT) in this population. The prognosis for SMT is poor, particularly with tumors of the lung and esophagus. The Rochester series was analyzed for larynx stage and specific SMT sites, possible common etiologic factors, and survival of the population as a whole, as well as for the SMT group. From a total of 235 patients with larynx carcinoma and a median follow-up of 10 years, 50 patients with 61 SMT were identified. The overall incidence of developing a SMT was 21%, with 44% of the SMT in the lung. The median survival from SMT diagnosis was 8.74 months and the 2-year survival was only 26%. More than twice as many SMT were observed than would be expected in the population at risk, with an observed-to-expected ratio (OER) for lung SMT of 5.3, and 8 times as many head and neck SMT occurring in our population. These SMT are not treatment related but are most likely caused by a combination of exposure to a common carcinogen, that is, tobacco smoke and alcohol, and to inherent factors, notably "condemned mucosa syndrome." Follow-up procedures, from the perspective of SMT development in larynx cancer patients, are addressed in an attempt to improve survival. The focus of this study is the high incidence of lung primaries that could be mistaken for metastatic disease, which is relatively uncommon in early larynx cancer patients.
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Affiliation(s)
- S McDonald
- Department of Radiation Oncology, University of Rochester School of Medicine and Dentistry, NY 14642
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Abstract
Lung cancer stands as the most important malignant neoplasm in the United States because of its high prevalence, increasing incidence, high rate of mortality, and great potential for prevention through the control of cigarette smoking. The World Health Organization (WHO) classification of lung cancer identifies four major types: squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and small cell carcinoma. These tumors are commonly divided into two groups based on differences in their biology and treatment: small cell (SCLC) and non-small cell carcinomas (NSCLC). This review analyzes NSCLC with a strong emphasis on the practical aspects of treatment. We give recommendations about smoking cessation and early diagnosis through screening of high-risk individuals. We review contemporary diagnostic and staging techniques in the context of the new international TNM system of staging. Subsequent discussions of treatment are based on this new staging system. We stress the pivotal role of surgery for the management of local disease, and in addition present the potential contributions of newer radiation therapy techniques. We examine chemotherapy in detail, including a review of the comparative activity of the available cytotoxic agents against NSCLC, the relative contribution of combination chemotherapy, and the role of surgical adjuvant treatment with either chemotherapy or immunotherapy. We advise that patients with NSCLC be treated under the aegis of modern clinical trials of new therapy whenever possible. When this is not possible, we recommend an individualized approach based on such factors as the patient's age, general state of health, cardiopulmonary status, psychosocial status, and personal system of values.
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Abstract
Maintaining smoking abstinence after a myocardial infarction (MI) greatly reduces risks of recurrent disease morbidity and of mortality. Although post-MI patients appear to have better long-term rates of smoking abstinence compared with healthy groups, studies employing biochemical verification of smoking status generally indicate that only about one third of previously smoking post-MI patients remain abstinent at follow-up. Factors which may accompany the occurrence of a MI and which may be associated with maintenance of smoking abstinence include environmental changes aiding cessation (e.g., decreased exposure to smoking cues), increased social support from family, and stronger belief in the harmful effects of continued smoking. The usefulness of these factors in developing new treatments for maintaining abstinence in post-MI patients is discussed, and commonalities between efforts to maintain smoking abstinence in post-MI patients and avoidance of substance abuse in other groups at risk for serious health consequences are briefly noted.
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Affiliation(s)
- K A Perkins
- Western Psychiatric Institute & Clinic, University of Pittsburgh School of Medicine, PA 15213
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Hartley MV, Tyler ML. Ineffective Airway Clearance Related to Airway Infection. Nurs Clin North Am 1987. [DOI: 10.1016/s0029-6465(22)01264-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Abstract
Lung cancer stands as the most important malignant neoplasm in the United States because of its high prevalence, increasing incidence, high rate of mortality, and great potential for prevention through the control of cigarette smoking. The World Health Organization (WHO) classification of lung cancer identifies four major types: squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and small cell carcinoma. These tumors are commonly divided into two groups based on differences in their biology and treatment: small cell (SCLC) and non-small cell carcinomas (NSCLC). This review analyzes NSCLC with a strong emphasis on the practical aspects of treatment. We give recommendations about smoking cessation and early diagnosis through screening of high-risk individuals. We review contemporary diagnostic and staging techniques in the context of the new international TNM system of staging. Subsequent discussions of treatment are based on this new staging system. We stress the pivotal role of surgery for the management of local disease, and in addition present the potential contributions of newer radiation therapy techniques. We examine chemotherapy in detail, including a review of the comparative activity of the available cytotoxic agents against NSCLC, the relative contribution of combination chemotherapy, and the role of surgical adjuvant treatment with either chemotherapy or immunotherapy. We advise that patients with NSCLC be treated under the aegis of modern clinical trials of new therapy whenever possible. When this is not possible, we recommend an individualized approach based on such factors as the patient's age, general state of health, cardiopulmonary status, psychosocial status, and personal system of values.
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