Preventive skin care beliefs of people with spinal cord injury

Although health beliefs have been correlated with self-care adherence in other chronic conditions, little is known about skin care beliefs after spinal cord injury (SCI). The purpose of this qualitative study was to identify the skin care beliefs of individuals with SCI. The conceptual framework was the Health Belief Model (HBM), which proposes that adherence to a health regimen is motivated by beliefs about susceptibility, severity, barriers, benefits, and self-efficacy. Purposive sampling was used to recruit 22 people with SCI. Content analysis of data collected using semistructured questions was used to identify domains of skin care beliefs, including HBM components. Themes that emerged about skin care beliefs included taking vigilant care, taking charge, maintaining health, and passing up care. Although most participants believed they were susceptible to pressure ulcers and preventive care was important, paradoxical statements about beliefs and preventive behaviors were common. These incongruent responses may reflect ambivalence about competing priorities or the efficacy of preventive practices. Further research is needed to understand this phenomenon. Increased understanding of skin care beliefs will assist in developing tailored teaching programs for people with SCI.     

Predictors of prostate cancer screening intention among older men in Jordan

Intention to prostate cancer screening (PCS) is one of the major factors affecting the long‐term success of population‐based PCS programmes. The aim of this study is to explore strong factors linked to intention to PCS among older Jordanian adults using the Health Belief Model (HBM). Data were obtained from Jordanian older adults, aged 40 years and over, who visited a comprehensive health care centre within a ministry of health. A pilot test was conducted to investigate the internal consistency of the Champion Health Belief Model Scale for PCS and the clarity of survey questions. Sample characteristics and rates of participation in PCS were examined using means and frequencies. Important factors associated with intention to PCS were examined using bivariate correlation and standard multiple linear regression analysis. About 13% of the respondents were adherent to PCS over the prior decade. Four out of the seven HBM‐driven factors (perceived susceptibility, benefits and barriers to prostate‐specific antigen (PSA) test, and health motivation) were statistically significant. Those with greater levels of susceptibility, benefits of PSA test and health motivation and lower levels of barriers to PSA testing were having more intention to participate in PCS. Family history, presence of urinary symptoms, age and knowledge about prostate cancer significantly predicted the intention to PCS. Intervention programmes, which lower perceived barriers to PSA testing and increase susceptibility, benefits of PSA testing and health motivation, should be developed and implemented.     

Do cultural factors predict mammography behaviour among Korean immigrants in the USA?

Title. Do cultural factors predict mammography behaviour among Korean immigrants in the USA? Aim. This paper is a report of a study of the correlates of mammogram use among Korean American women. Background. Despite the increasing incidence of and mortality from breast cancer, Asian women in the United States of America report consistently low rates of mammography screening. A number of health beliefs and sociodemographic characteristics have been associated with mammogram participation among these women. However, studies systematically investigating cultural factors in relation to mammogram experience have been scarce. Methods. We measured screening‐related health beliefs, modesty and use of Eastern medicine in 100 Korean American women in 2006. Hierarchical logistic regression was used to examine the unique contribution of the study variables, after accounting for sociodemographic characteristics. Findings. Only 51% reported past mammogram use. Korean American women who had previously had mammograms were statistically significantly older and had higher perceived benefit scores than those who had not. Perceived benefits (odds ratio = 6·3, 95% confidence interval = 2·12, 18·76) and breast cancer susceptibility (odds ratio = 3·18, 95% confidence interval = 1·06, 9·59) were statistically significant correlates of mammography experience, whereas cultural factors did not correlate. Post hoc analysis showed that for women with some or good English skills, cultural factors statistically significantly correlated with health beliefs and breast cancer knowledge (P < 0·05). Conclusion. Nurses should consider the inclusion in culturally tailored interventions of more targeted outreach and healthcare system navigation assistance for promoting mammography screening in Korean American women. Further research is needed to unravel the interplay between acculturation, cultural factors and health beliefs related to cancer screening behaviours of Korean American women.     

Reliability and validity of the mammography screening beliefs questionnaire among Chinese American women

Cancer is the leading cause of death for Asian American women, and the breast is a primary site of cancer in Chinese women. Although a number of studies have used constructs from the Health Belief Model (HBM) to examine their relation to mammogram screening, the validity and reliability of the instruments on HBM constructs among Chinese women have not been consistently examined. The purpose of this study was to describe the psychometric properties of a culturally sensitive questionnaire for measuring Chinese women's beliefs (susceptibility, seriousness, benefits, and barriers) related to breast cancer and mammogram screening. The items developed for the questionnaire were drawn from a comprehensive literature review and focus groups. The instrument was translated using back translation technique and evaluated by a panel of professional experts and lay experts. A total of 220 Chinese American women ages 40 to 85 years residing in a suburban Midwestern community were included in the sample. Psychometric testing demonstrated satisfactory internal consistency and validity of the instrument for this group of women. The Cronbach alpha for the subscales ranged from.77 to.90. Construct validity was supported by exploring the factor structure of the instrument using confirmatory factor analysis and testing correlations with mammography compliance.     

Health beliefs, health locus of control, and women's mammography behavior

Research has shown that routine mammography screening can significantly reduce mortality from breast cancer. The use of mammography screening, however, remains well below national goals. In an effort to understand the factors that influence women's mammography behaviors, this study explored the relation between health beliefs, locus of control, and women's mammography practice. Survey instruments used were Champion's health belief scales and the Multidimensional Health Locus of Control (MHLC) scales. The study used a convenience sample of 25 African Americans and 72 white women ages 35 to 84. Findings showed that women who participated in mammography screening were significantly more likely to perceive greater benefits, greater health motivation, and fewer barriers to screening than those who did not participate. These same three variables were similarly associated with greater frequency of receiving mammograms. It also was found that perceived benefits and health motivation were significantly correlated with shorter duration of time since the last mammogram. No support was found for perceived susceptibility, perceived seriousness, and health locus of control as predictors of women's mammography behavior. Implications for nursing research in further examining the MHLC and the Health Belief Model construct of susceptibility as they relate to mammography behavior are identified. Practice implications for nurses are suggested.     

Mammography screening behavior in older women caregivers

The purposes of this study are to explore older caregivers' mammography participation and the facilitators and barriers to mammography screening. Of the 52 older female caregivers with a mean age of 65 years (range 50-90) interviewed by telephone, 80.8% had had a mammogram within 12 months. Significant facilitators included health care provider recommendation and beliefs in the efficacy of treatment. Significant barriers included health care providers' failure to recommend mammograms, caregiver procrastination, fear of pain, and lack of symptoms. Caregivers with higher burden reported less frequent self- and provider-conducted breast examinations.     

The effectiveness of a nurse-delivered breast health promotion program on breast cancer screening behaviours in non-adherent Turkish women: A randomized controlled trial

Background

Few studies have investigated breast health programs to promote rates of having a mammography, clinical breast examination and breast self-examination among non-adherent Turkish women.

Objectives

To determine the effectiveness of a breast health promotion program on mammography and clinical breast examination use, breast self-examination frequency and proficiency (breast self-examination skills and lump detection), breast health knowledge and health beliefs about breast cancer screening in a sample of Turkish women.

Design

Experimental (pretest-posttest control group).

Setting

A community-based setting in Istanbul, Turkey.

Participants

190 Non-adherent women (intervention group = 97, control group = 93) aged 41 and older, residing in Istanbul, Turkey.

Methods

The intervention group (n = 97) received a 120-min breast health promotion program based on health belief model including a breast health education, film, breast self-examination instruction, and a booklet, a calendar, a card designed specifically for the study. The control group (n = 93) received general information except breast health. Data were collected before the program, immediately after the program, and at 3- and 6-month post-program. The outcome measures are the mammography, clinical breast examination, and breast self-examination frequency, breast self-examination proficiency, breast health knowledge, and health beliefs (perceived susceptibility to breast cancer, benefits to mammography and breast self-examination, barriers of mammography and breast self-examination, confidence in performing breast self-examination).

Results

The breast health promotion program significantly increased breast self-examination frequency and proficiency and breast health knowledge. No significant differences existed in mammography and clinical breast examination rates between the two groups at 6 months. The program was effective in increasing perceived susceptibility to breast cancer, perceived benefits of mammography and breast self-examination, and confidence of breast self-examination. No significant difference was found between the two groups for perceived barriers to mammography.

Conclusions

The breast health promotion program was effective in increasing breast self-examination frequency and proficiency in a sample of Turkish women. In addition, it appears to be useful in raising the knowledge of breast health, enhancing confidence in performing breast self-examination, and increasing most health belief levels.     

Health care service utilization among the elderly: findings from the Study to Understand the Chronic Condition Experience of the Elderly and the Disabled (SUCCEED project)

Rationale and objectives Age‐related effects on health service utilization are not well understood. Most previous studies have examined only a single specific health care service or disease condition or have focused exclusively on economic variables. We aim to measure age‐related change in health care utilization among the elderly. Methods A population‐based retrospective cohort study was conducted using linked data from four administrative databases (OHIP, ODB, CIHI and RPDB). All Ontario residents over the age of 65 years and eligible for public health coverage were included in the analysis (approximately 1.6 million residents). Main outcome measures include utilization indicators for family physician visits, specialist physician visits, Emergency Department visits, drugs, lab claims, X‐rays, inpatient admissions, CT scans and MRI scans. Results The mean number of utilization events for Ontarians aged 65+ years for the 1‐year study period was 70 events (women = 76, men = 63). The overall absolute difference between the 65–69 age group and the 85+ age group was 155% (women = 162%, men = 130%), or 76 more events per person in the older group (women = 82, men = 61). Women averaged more events per person than men, as well as greater percentage differences by age. Drugs and diagnostics account for the majority of events. Only MRI and specialist visits were not higher among the older age groups. Conclusions At the population level, overall health care utilization would appear to increase significantly with age. It is unclear whether increasing health care utilization prevents morbidity, decreases mortality, or improves quality of life.     

The role of exercise in the African-American woman with type 2 diabetes mellitus: application of the health belief model

PURPOSE: To determine whether aging African-American women with a diagnosis of type 2 diabetes mellitus who maintain a regular exercise regimen possess different health beliefs and benefit from greater glycemic control than those who do not exercise regularly. DATA SOURCES: A 32-item health belief model diabetes scale was administered to a convenience sample of 31 African-American women with type 2 diabetes. CONCLUSIONS: A group t-test identified statistically significant differences between "exercisers" and "non-exercisers" in perceived benefits and barriers to exercise and glycemic control. IMPLICATIONS FOR PRACTICE: Findings may be utilized in the development of diabetic educational programs and compliance-enhancing treatment interventions that focus on the barriers and benefits of diabetes self-management.     

The influence of social support relationships on mammography screening in African-American women.

Evidence indicates that mammography screenings have increased in African-American women who are 50 years of age or older; however, they continue to experience later-stage discovery and poorer survival rates from breast cancer compared to White women. Although research has consistently found that social support relationships affects mammography screening in African-American women, little is known about the preventive health behaviors of individuals in these relationships that may be associated with mammography screening. This study examined that association and found that social support relationships, defined as blood-relatives and extended kinship networks, stressed personal responsibility and accountability for preventive health; therefore, supporting mammography screening. Of perhaps the greatest importance, the relationships emphasized positive strengths of African-American culture and invoked the necessity to confront prior negative experiences in health-care systems. These relationships also negated the fears or fatalistic beliefs about breast cancer that had been perpetuated by myths through informal communication and "deliberate silence" from significant others who had previously discouraged or de-emphasized the importance of mammography screening. Further research is needed to determine if the emphasis on cultural heritage was the only motivator that encouraged personal responsibility for mammography screening.     

Jordanian Muslim women's intention to use oral contraceptives

Oral contraceptives (OCs) are the second most popular method of contraception in Jordan; however, their use remains low compared with the intrauterine device. The purpose of this article is to report the effect of factors identified by The Theory of Planned Behavior (TPB) on Jordanian Muslim women's intention to use OCs. TPB was used to develop an investigator-developed instrument, the Intention to Use Oral Contraceptive Tool (IUOCT). The IUOCT measured attitude (general attitude and attitudinal beliefs), social norms and perceived behavioral control factors in a total of 83 women participants. A stepwise regression analysis was calculated using the IUOCT subscales as predictors of Jordanian Muslim women's intention to use OCs. The findings demonstrated that the attitude, specifically general attitude and positive beliefs, about OC use affect Jordanian Muslim women's intention to use OCs. However, the findings provide limited support for social norms and perceived behavioral control as factors influencing Jordanian Muslim women's intention to use OCs. The findings indicate that more attention should be devoted to health education programs on the benefits of using OCs rather than focusing only on correcting misinformation. Nursing implications and recommendations for future research are discussed.     

Knowledge, barriers, and motivators related to cervical cancer screening among Korean-American women. A focus group approach

Cervical cancer is a significant health problem for Korean-American women. It currently is the number one female cancer diagnosed among women in South Korea. Despite this fact, Korean-American women have very low rates of cervical cancer screening. The purpose of this research were to gain an understanding of Korean women's knowledge about cervical cancer, and to identify major barriers to early screening for cervical cancer and the motivators for prevention and early detection. It is hoped that the findings will guide the development of community-based cervical cancer education and screening programs for adult Korean-American women. The health belief model (HBM) provided the theoretical basis for the study. A qualitative study with eight focus groups (n = 102) was conducted using 11 questions derived from the HBM. Focus group discussions revealed that there was misinformation and a lack of knowledge about cervical cancer. The women therefore were confused about the causative factors and preventive strategies related to cervical cancer. The findings showed that major structural barriers were economic and time factors along with language problems. Many participants were recent immigrants with no medical insurance and long work hours. The main psychosocial barriers were fear/fatalism, denial, and Confucian thinking. Participants stated that medical advice and education would influence them most to undergo a Pap test. Recommendations were made to reduce certain barriers and to increase knowledge and motivations.