Psychometric Evaluation of a New Instrument to Measure Uncertainty in Children and Adolescents With Cancer

Although uncertainty has been characterized as a major stressor for children with cancer, it has not been studied systematically

Test of a conceptual model of uncertainty in children and adolescents with cancer

Despite recognition as a significant stressor in childhood cancer, illness-related uncertainty from the perspective of children remains under-studied. We tested a conceptual model of uncertainty, derived from Mishel’s uncertainty in illness theory, in 68 school-aged children and adolescents with cancer. As hypothesized, uncertainty was significantly related to psychological distress, but only one hypothesized antecedent (parental uncertainty) significantly predicted children’s uncertainty. An alternative model incorporating antecedent developmental factors (age and illness-specific expertise) explained 21% of the variance in child uncertainty; controlling for stage of treatment, uncertainty was higher in children with shorter time since diagnosis, older age, lower cancer knowledge, and higher parental uncertainty. These findings provide the foundation for further studies to understand children’s management of uncertainty and its contribution to psychological adjustment to illness

Breast Cancer Risk Perception and Lifestyle Behaviors Among White and Black Women With a Family History of the Disease

Little is known about relationships between a positive family history of breast cancer, perception of risk, and lifestyle behaviors. This qualitative study explored factors involved in formulation of perceived breast cancer risk and the association between risk perception and lifestyle behaviors in white and black women with a family history of breast cancer. Eligible participants were North Carolina residents in the Sister Study, a nationwide study of environmental and genetic risk factors for breast cancer among women aged 35 to 74 who have at least one sister diagnosed with breast cancer. Personal interviews were conducted with thirty-two women, twenty white and twelve black. While many had a heightened sense of risk and perceived family history as a main risk factor, 16% considered themselves at low or average risk for breast cancer and Gail risk scores did not correspond to perceived risk. Many women were unaware of associations between lifestyle behaviors and breast cancer risk. Eleven women, six black and five white, reported making healthy lifestyle changes because of family history; dietary change was most frequently reported. These findings may be important for future developers of breast cancer education programs for both white and black women with a family history of breast cancer

Thoughts and behaviors of women with symptoms of acute coronary syndrome

Women delay seeking care for symptoms of Acute Coronary Syndromes (ACS) because of atypical symptoms, perceptions of invulnerability, or keeping symptoms to themselves. The purpose of this study was to explore how women recognized and interpreted their symptoms and subsequently decided whether to seek treatment within the context of their lives

Predictors and patterns of participant adherence to a cortisol collection protocol

Cortisol, a stress-related hormone, has been measured in many psychoimmunological studies via collection of saliva; however, patterns of participant adherence to protocol procedures are rarely described in the literature

Patients with chronic hepatitis C undergoing watchful waiting: Exploring trajectories of illness uncertainty and fatigue

We identified trajectories of illness uncertainty in chronic hepatitis C patients and examined their association with fatigue levels during 12 months of disease monitoring without treatment (watchful waiting). Sixty-two men and 63 women completed uncertainty and fatigue measures. Groups were formed by uncertainty scores (high, medium, low) at baseline. Baseline fatigue levels were higher in the high uncertainty group than in the medium and low groups. Over time, uncertainty levels did not change. Fatigue levels in the low uncertainty group remained constant, increased in the medium, and decreased in the high groups. Findings suggest that uncertainty and fatigue do not remit spontaneously. Being aware of this may help nurses identify those patients needing support for these two concerns

Receipt of NCCN Guideline-Concordant Prostate Cancer Care among African- and Caucasian-American Men in North Carolina

African Americans have a higher incidence of prostate cancer and experience poorer outcomes compared to Caucasian Americans. Racial differences in care are well documented. However, few studies have characterized patients based on their prostate cancer risk category, which is required to differentiate appropriate from inappropriate guideline application

Engaging African American breast cancer survivors in an intervention trial: culture, responsiveness and community

Younger breast cancer survivors often lead extremely busy lives with multiple demands and responsibilities, making them difficult to recruit into clinical trials. African American women are even more difficult to recruit because of additional historical and cultural barriers. In a randomized clinical trial of an intervention, we successfully used culturally informed, population-specific recruitment and retention strategies to engage younger African-American breast cancer survivors

Associations between patient–provider communication and socio-cultural factors in prostate cancer patients: A cross-sectional evaluation of racial differences

To examine the association between socio-cultural factors and patient-provider communication and related racial difference

Patient-health care provider communication among patients with newly diagnosed prostate cancer: Findings from a population-based survey

To examine the multidimensional concept of patient-health care provider (HCP) communication, its effects on patient satisfaction with oncology care services, and related racial differences