Alice J. Longman

Breast Cancer Screening among Older Hispanic Women: Knowledge, Attitudes, and Practices

A survey was conducted with 409 Hispanic and 138 Anglo women in Tucson, Arizona, to assess their knowledge of breast cancer and cancer screening tests, their attitudes toward breast cancer and cancer screening, and their use of screening tests. There were few differences between these two groups in use of breast cancer screening tests, with both groups falling well below the recommended levels of screening frequency. Clinical breast exam was most often used, followed by breast self-exam, with mammography a distant third. Levels of knowledge about the risks for breast cancer and the ways to detect it were also low. Comparison with national data show Arizona women to have lower rates of breast cancer screening than the national average; this may be due to the absence of the Medicaid program in Arizona. The rates for Tucson Hispanics, although lower than that for Anglos, are comparable with the findings of other studies. More needs to be done to alert all older women about breast cancer screening, but more specific attention needs to be paid to the population of older Hispanic women. We suggest some culturally relevant strategies to address this problem.

Depression Burden, Self-Help Interventions, and Social Support in Women Receiving Treatment for Breast Cancer

Abstract The purpose of this article is to describe the interaction effects of depression burden (depressive symptoms experienced as a burdensome side effect) with a set of oncology support interventions on social support for women receiving treatment for breast cancer. A repeated measures design was used with measurement occurring at three points in time: T1 (baseline after adjuvant medical treatment was initiated), T2 (six to eight weeks after T1) and T3 (three months after T2). Two hundred forty-seven women were randomly assigned to treatment (n = 194) or control (n = 53). The treatment group consisted of women participating in three different, but complimentary self-help interventions. Depression burden, even at low levels, influenced the critical dimensions of social support structure, function, and nature.

Effectiveness of a Hospice Community Bereavement Program.

The purpose of this longitudinal pilot study was to assess the extent of unresolved grief in bereaved individuals attending two programs offered by St. Marys Hospice, to assess their spiritual perspectives, and to describe the relationship between them. The differences in individuals attending the programs at two time periods were also examined. Fifty-six individuals completed two questionnaires at Time 1 and forty-two individuals completed the same questionnaires three months later. The results indicated that these individuals manifested initial reactions to the death and that these reactions were somewhat lessened three months later. Participants who expressed some belief in a spiritual perspective used this to assist them in their bereavement. That the programs were of benefit to the participants were evident by their comment.

Preliminary evaluation of bereavement experiences in a hospice program.

The purpose of this study was to determine how the services of a bereavement program could be more helpful to survivors following the death of a spouse and/or significant other. Ninety-seven bereaved individuals were interviewed thirteen months after the death over a period of two years. The results of this pilot study revealed that most of the subjects were managing their lives and coping with their loss without undue stress. Overall, subjects were satisfied with the services of the hospice program and were experiencing recovery. Implications for further study and practice are discussed.

Sensory-perceptual experiences of bereaved individuals. Additional cues for survivors.

Hospicecareaddresses the problemsthat areuniqueto the dying personandassists patientsandtheir families as a unit of care.An aspectof hospicecareis bereavement counselingafter the deathof thepatientprovidedto the family and/or thosewhohave beenresponsiblefor care. St. Mary’s Hospiceis ahospital-based,Medicarecertified programprovidinghomecare, inpatientcare,andbereavement follow-up. The Hospice BereavementProgramis comprehensiveandoffersvolunteerhomevisits, individual andgroup counseling,asix-

Research utilization: An evaluation and critique of research related to oral temperature measurement

The problem addressed was whether a research-based protocol on oral temperature measurement could be developed and used in the practice setting. The first phase of the study proposed to (a) identify research articles related to the subject; (b) evaluate the quality of the research; (c) assess the adequacy of the research base; and (d) select areas for future study. The results indicated that further clinically-based studies are needed before a protocol can be designed and tested in clinical practice.

Side effects burden in women with breast cancer.

PURPOSE This article describes the side effects burden of 307 women who were receiving treatment for breast cancer. The study provides a description of the impact of side effects burden on adult role activities (self-help), self-care, psychological adjustment, and quality of life. DESCRIPTION OF STUDY Data to describe the side effects burden characteristics of 307 women receiving treatment for breast cancer were drawn from the Self-Help Intervention Project. Data were collected after medical treatment was underway and treatment-related side effects were evidenced. The impact of side effects burden on adult role activities (self-help), self-care, psychological adjustment, and life quality is described. RESULTS Fatigue was the most common side effect as well as the most problematic. Number of side effects and increase in side effects were moderately correlated (P < 0.0001) in a negative direction with fatigue and depression. Self-care behaviors also were associated negatively with the extension of side effects and with fatigue and depression (P < 0.001). Psychological adjustment was associated with difficulty sleeping, anxiety, and depression. Overall life quality was noted to be negatively related to depression as was present life quality. CLINICAL IMPLICATIONS Data support the need for clinical interventions that are individualized to womens side effects experience. Additional research is underway to test the effectiveness of the interventions specified by the overall study.