Cecelia Gatson Grindel

Cancer Prevention and Screening Behaviors in Lesbians

SUMMARY The incidence of cancer diagnosis has increased in the United States highlighting the need for astute cancer prevention and screening behaviors. Previous literature has suggested that lesbians may not follow the American Cancer Societys (ACS) guidelines regarding prevention and screening for cancer due to disparity in access to care and increased use of alcohol and tobacco. The purpose of this study was to examine the cancer prevention and screening behaviors of lesbians using the ACS guidelines as the standards for comparison, and to determine factors that influence mammography screening. A 102-item self-report survey was distributed to lesbians nationwide using various methods including snowballing sampling techniques. The sample included 1139 self-identified lesbians from 44 states. In general, healthy lifestyle behaviors were followed. The majority of the women did not smoke, ate plenty of fruits and vegetables, ate protein sources low in fat and consumed alcohol at a moderate rate. However, safe sex practices were often not used by participants. Most women did have mammograms and Papanicolaou smears (PAP) as recommended; however, adherence to self-breast examination guidelines was not followed. Women who were older, had higher yearly incomes, did not smoke, performed regular self breast exams and had regular physical exams were most likely to have a mammogram. Over half of the women met American Cancer Society guidelines for prevention and screening for breast and cervical cancer. However, strategies are needed to increase compliance with these guidelines in order to improve cancer health outcomes.

Comparison of Symptoms of Younger and Older Patients Undergoing Coronary Artery Bypass Surgery

Little is known about the symptom experience throughout the trajectory of recovery for patients after coronary artery bypass surgery (CABS). This study investigates the preoperative and postoperative symptoms experienced by younger (< 65 years) and older (= 65 years) patients (N= 102) who had undergone CABS. Reported preoperative symptoms were angina, shortness of breath, dizziness, and sweating. At 1 week post-CABS, symptoms were incisional pain, wound drainage, chest congestion, shortness of breath, dizziness, sweating, swollen feet, and loss of appetite; incisional pain and swollen feet were reported by a few patients at 6 weeks after CABS. The incidence and frequency of postoperative symptoms declined over time. There were several age-related differences in symptom reports prior to and at 1 and 6 weeks after the procedure. Such information can be used to plan the care of patients undergoing CABS, to prepare them for normal recovery, and to determine the need for symptom management by health care providers.

Students' decisions to select HIV services for clinical experiences.

The ever-growing numbers of persons living with HIV/AIDS emphasizes the need for highly trained healthcare professionals to care for this population. Understanding why nursing and medical students would choose HIV services for clinical rotations, and the impact of those clinical experiences on their future professional practice, is key to recruiting healthcare providers to care for this population.

Risk classification, clinical outcomes, and the use of nursing resources for cardiac surgery patients.

Several studies have used risk classification models to examine the effect of preoperative risk factors on operative morbidity and mortality. However, previous research has not linked risk classification models to factors such as frequency of postoperative complications, length of intensive care unit stay, mortality, and the use of nursing resources. This article reports on significant differences in clinical outcomes and hours of nursing care by risk classifications.

Remembering Those Who Have Gone Before: The Importance of AIDS Memorial Services for Families and Friends

In the 1980s and early 1990s, numerous deaths of people with AIDS resulted in regularly sponsored memorial services for families and friends. Since the advent of highly active antiretroviral therapies, people living with AIDS experience longer life expectancy. Subsequently, memorial services have gradually been eliminated, primarily due to a decreased death rate among those who are HIV infected. The purpose of this study was to examine the meaning of an annual memorial service for loved ones who had lost someone to AIDS. Thirty-four family members and friends participated in telephone interviews and provided descriptions of the meaning of the annual memorial service. Findings revealed that this service assured them that the deceased was not forgotten. Often, the memorial service was the only outlet families, particularly members of minority and disenfranchised groups, had to mourn the deceased. Persons who attended the service found it comforting to gather to remember loved ones lost to AIDS.

Circle of Care: Beyond HIV Counseling and Testing

Many HIV counseling and testing programs do not link both seropositive and seronegative individuals with comprehensive services after HTV testing. East Boston Neighborhood Health Center implements HIV counseling and testing in four programs: (1) a confidential program for existing clients; (2) an anonymous test site serving inner-city residents; (3) a mobile unit serving courts, methadone clinics, and substance abuse programs; and (4) a screening clinic for immigrants. This paper presents counseling and testing data from these programs for two periods. In addition, data on referrals for both seropositive and seronegative individuals from the anonymous test site and mobile unit are reported. Personalized referrals ensure that newly seropositive individuals are immediately engaged in comprehensive HIV care. Referrals for individuals with high-risk behaviors help maintain their HIV negative status as well as promote early HIV detection and intervention. In addition, referrals that extend to families and social networks complete the circle of care.