Cancer patients' attitudes towards Chinese medicine: a Hong Kong survey

Background  

This article reports a survey conducted in Hong Kong on the cancer patients' attitudes towards Chinese medicine treatment.     

Computers in medicine: patients' attitudes

Data are presented from two surveys where a 26-item questionnaire was used to measure patients' attitudes to diagnostic computers and to medical computers in general. The first group of respondents were 229 patients who had been given outpatient appointments at a hospital general medical clinic specializing in gastrointestinal problems, where some had experienced a diagnostic computer in use. The second group of respondents were 416 patients attending a group general practice where there was no computer. Patients who had experience of the diagnostic computer or a personal computer had more favourable attitudes to computers in medicine as did younger people and males. The two samples of patients showed broadly similar attitudes, and a notable finding was that over half of each group believed that, with a computer around, the personal touch of the doctor would be lost.     

Staff conceptions of patients' attitudes toward mental disorder and hospitalization as compared to patients' and staff's actual attitudes.

Compared ward personnel's (N = 25) conceptions of their patients' attitudes toward mental disorder and hospital atmosphere to the patients' (N = 50) and the personnel's actual attitudes by use of the CPH Factor Scale. Personnel completed the scale as (1) they themselves viewed the hospital; and (2) as they thought their patients viewed it. Patients' views also were obtained. Personnel viewed the hospital in "positive mental health" terms and considered the patients to be significantly less so. In actually, patients were less positive than personnel, but significantly less extreme than they were considered to be by the personnel. This approach suggests a means to provide an index discrepancy in attitude between patient and personnel. Identifying these descrepancies can allow for correction and improved understanding empathy, and patient care.     

Changes in patients' attitudes towards the management of minor ailments

BACKGROUND: Patients' attitudes towards the management of minor ailments influence help-seeking behaviour. Up-to-date information about patients' attitudes is valuable for understanding changes in help-seeking behaviour. AIM: To describe changes in patients' attitudes between 1987 and 2001, and to explain the relationship between patients' attitudes and attributes of practices, practitioners and patients. DESIGN: Two cross-sectional, Dutch National Surveys of General Practice (1987 and 2001; n = 9579 and n = 8405 patients, respectively). SETTING: General practice in the Netherlands. METHOD: Patients' attitudes were evaluated in health interviews. Data were analysed using multilevel regression analysis. RESULTS: In 2001, patients' attitudes showed a shift away from consulting their GP for minor ailments. Attitudes are uniform across different types of practice, and mainly differ between patients. In 1987 as well as in 2001 the factors associated with firm beliefs about the benefits of GP's care in case of minor ailments were male, older age, lower educational level, a non-Western cultural background, and a visit to the GP in the past 2 months. Furthermore, the association between health status and beliefs about GPs dealing with minor ailments is more marked in 2001. Compared to 1987, the influences of GPs and the practice are more intertwined in 2001. CONCLUSIONS: Patients' attitudes towards the management of minor ailments have changed over the years, which implies that strategic action by the profession and the government has affected the way the public uses primary care. However, a marginal group of patients (elderly, less-educated, non-Western) is lagging behind this trend, and continuing to consult GPs for minor ailments.     

Preimplantation genetic diagnosis: patients' experiences and attitudes

BACKGROUND: This study aims to report the experiences and attitudes of patients who have undergone preimplantation genetic diagnosis (PGD). The extent to which this technique is acceptable to the individuals for whom it is intended is relatively unexplored, and remains a crucial issue that may ultimately determine the value of PGD as an alternative to prenatal diagnosis in high-risk couples. METHODS: An information sheet and questionnaire was distributed to 67 couples who had been treated at the Hammersmith Hospital, London and the Dexeus Institute, Barcelona. RESULTS: One-third of patients had an affected child, over half had previous experience of conventional prenatal diagnosis and over one-third had had terminations of pregnancy because of a genetic risk. Patients perceive the main advantage of PGD to be that only unaffected embryos are transferred to the uterus and thus therapeutic termination of pregnancy can be avoided; the main disadvantage is the low success rate. A total of 41% of patients found the treatment cycle extremely stressful, and, of the 20 patients who had experienced both prenatal diagnosis and PGD, 40% of patients found PGD less stressful, although 35% experienced more stress. Of those couples who contemplated a further pregnancy 76% would choose PGD, 16% would opt for prenatal diagnosis, and 8% no tests at all. CONCLUSIONS: The experience of prenatal diagnosis and termination of pregnancy can be an unwelcome memory and this leads to a demand for an alternative approach. Our data suggest that PGD is acceptable to patients and is a valuable alternative to prenatal diagnosis.     

A survey of patients' attitudes to clinical research

Every year hundreds of patients voluntarily participate in clinical trials across Ireland. However, little research has been done as to how patients find the experience. This survey was conducted in an attempt to ascertain clinical trial participants' views on their experience of participating in a clinical trial and to see and how clinical trial participation can be improved. One hundred and sixty-six clinical trial participants who had recently completed a global phase IV cardiovascular endpoint clinical trial were sent a 3-page questionnaire. Ninety-one (91%) respondents found the experience of participating in a clinical trial a good one with 85 (84.16%) respondents saying they would recommend participating in a clinical trial to a friend or relative and eighty-five (87.63%) respondents feeling they received better healthcare because they had participated in a clinical trial.     

Psychiatric patients' attitudes towards concordance and shared decision making

Objectives

To assess psychiatric outpatients’ attitudes towards concordance and shared decision making in a psychiatric setting and to evaluate the role that self-perceived knowledge and beliefs about psychiatric medicines play in those attitudes.

Methods

The Leeds Attitude to Concordance Scale (LATCon) was tested on a sample of 435 psychiatric outpatients. Principal Component Analysis was used to assess the structure of LATCon items. Regression analysis on LATCon scores was performed with sociodemographics, Belief about Medicines Questionnaire (BMQ) subscales, self-perceived knowledge, perceived psychiatrist behaviour and current medications as predictor variables.

Results

The LATCon scale showed a good factorial validity, with a monofactorial structure and high internal consistency. Psychiatric outpatients tended to be in agreement with the concept of concordance, but they did not share some relevant aspects of the construct. Cognitive representations of psychiatric medications, assessed by the BMQ subscales, significantly predicted scores on the LATCon scale.

Conclusion

Psychiatric outpatients show a considerable desire to participate in decision making about their treatment. The Spanish version of the LATCon Scale seems to be a valid instrument.

Practice implications

Psychiatrists must consider their patients’ desire to participate in treatment decisions and explore how patients’ views about psychiatric medications influence their attitudes towards concordance.     

Evaluation of resident attitudes and self-reported competencies in health advocacy

Background  

The CanMEDS Health Advocate role, one of seven roles mandated by the Royal College of Physicians and Surgeons Canada, pertains to a physician's responsibility to use their expertise and influence to advance the wellbeing of patients, communities, and populations. We conducted our study to examine resident attitudes and self-reported competencies related to health advocacy, due to limited information in the literature on this topic.     

Cancer patients' satisfaction with doctors and preferences about death in a university hospital in Turkey

Objective

To determine the expectations and satisfaction levels of Turkish cancer patients regarding their doctors, their wishes about the place and process of dying and to elucidate factors affecting them.

Methods

For this cross-sectional study, a self-administered questionnaire was given to 150 cancer patients in 2009.

Results

Among respondents, 63% stated that they would like to know all the details about their disease and they generally preferred a sudden, painless death, without any intervention at the last moment, but in a hospital. Almost all wanted a religious ceremony after their death. The question with the highest reported level of satisfaction was whether patients had complete trust in their doctors, whereas the least satisfaction was reported for doctors’ explanations during visits. Gender, tumour type and level of education had statistically significant effects on patient satisfaction.

Conclusion

The majority of our cancer patients trusted doctors and wanted to learn more about the progress of their cancer, in contrast to the general tendency of their families to hide the diagnosis. The hospital is still the most preferred place for dying.

Practice implications

Alterations in communication may lead to disparities in patient outcomes; therefore, communication skill training should guide clinicians to recognise these tendencies.     

Treatments for irritable bowel syndrome: patients' attitudes and acceptability

Background  

Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable.     

Provider attitudes and self-reported behaviors related to hormone replacement therapy.

OBJECTIVE: The purpose of this study was to survey providers within a large health maintenance organization regarding their attitudes and practice patterns related to counseling women about hormone replacement therapy (HRT). DESIGN: A total of 260 providers from gynecology (n = 81), family practice (n = 96), and internal medicine (n = 83) from owned and contracted clinics were surveyed. Each was asked about prescribing philosophies, behaviors, and barriers to providing counseling regarding HRT. RESULTS: Respondents reported HRT's greatest benefit to be in the prevention of osteoporosis (99%) and cardiovascular conditions (96%). Gynecologists were more likely to report the benefits of HRT for Alzheimer's than were clinicians in internal medicine or family practice (p < 0.05), and women providers were more likely than men to report this (p < 0.01). There was no statistical difference based on years in practice. Providers did not vary significantly by specialty or sex in their concerns of risk for breast cancer of endometrial cancer. However, those in family practice and internal medicine were significantly more likely to report concern about thromboembolism (p < 0.01). Only 42% of physicians claimed to initiate discussion with their patients more than 75% of the time. The two factors most often mentioned as barriers to counseling were time and lack of adequate knowledge. CONCLUSIONS: Providers want to be an integral part of their patient's education regarding HRT; however, time constrains and a need for adequate information make this difficult. Now health systems must examine models of education for both providers and patients to ensure that women have access to current information with which to make informed decisions.     

Demythologizing mental patients' attitudes toward mental illness: an empirical study

In an attempt to change the medical model attitudes of psychiatric patients in a direction more congruent with the radical psychosocial approach of their clinicians, an experimental group of 13 outpatients was exposed to a series of demythologizing seminars. As predicted, when compared to the attitudes of nontreatment controls (N = 13), on posttest and on a three month follow-up, results indicated that only the patients receiving the demythologizing seminars reported significant and stable attitude changes in the expected direction.     

An investigation of patients' attitudes to ECT by means of Q-analysis

This paper is a preliminary investigation into the application of Q-analysis in clinical psychiatry. Q-analysis is used to describe the interrelationships of attitudes that two groups of patients were observed to hold towards ECT. The data were collected as part of the Leicestershire ECT trial. One group comprised 96 patients who consented to enter the trial. The other group was formed by 23 patients who refused to participate in the trial, but who agreed to be interviewed so that their attitudes could be assessed. The method of applying Q-analysis is described, and the resultant outputs for the two groups are discussed. The presence of insight, a subjective need for treatment and trust in ECT were significant features in the 96 patients who agreed to enter the trial. However, among this group there was a subset of patients who were very anxious and who had little desire to receive ECT or trust in it. Among the 23 patients who refused to participate in the trial two main viewpoints could be discerned. First, there was a subgroup who seemed accurately to assess their need for treatment, had insight and trust in ECT as well as specifically wanting to receive it. The second was composed of patients who were very apprehensive, did not want ECT and generally were unhappy about being in hospital. In both groups it was considered that level of knowledge was relatively unimportant in the formation of attitudes.     

Factors associated with patients' knowledge of and attitudes towards treatment with lithium

BACKGROUND: Treatment with lithium is often compromised by poor adherence, by side-effects and by patients' having serum levels outside the therapeutic range. These factors may be affected by patients' knowledge and attitudes towards lithium, and we set out to establish factors associated with knowledge about and attitudes towards lithium among a large representative sample of patients. METHOD: Patients known to be taking lithium in Grampian during 1995 were surveyed postally during 1998 with the Lithium Knowledge Test (LKT) and the Lithium Attitudes Questionnaire (LAQ). Scores on these measures were analysed against patients' sociodemographic and clinical characteristics by stepwise multiple regression. RESULTS: Of 742 patients, 411 (55%) completed an LKT and 362 (49%) completed an LAQ. Stepwise multiple regression established that positive attitudes towards lithium on the LAQ were associated with higher serum lithium levels (P=0.005) and with continuing to take lithium (P<0.001). Higher knowledge on the LKT was associated with positive attitudes on the LAQ (P=0.002), with younger age (P<0.001), and with shorter duration of treatment (P=0.01) LIMITATIONS: The study was retrospective and the response rate was relatively low. CONCLUSIONS: Education about lithium is likely to be of particular importance in the elderly and 'refresher courses' are advisable for those who have been on lithium for lengthy periods. Interventions which modify attitudes, rather than enhancing knowledge, are likely to be helpful in promoting adherence.     

Beliefs about medicines and self-reported adherence among pharmacy clients

OBJECTIVES: To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. METHODS: The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). RESULTS: Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. CONCLUSIONS: General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. PRACTICE IMPLICATIONS: Increased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.     

General practice patients' beliefs about their symptoms.

BACKGROUND: Patients' beliefs about symptoms are major influences on consultation and its consequences. However, little information is available about the beliefs of patients when they consult their general practitioner (GP). AIM: To describe and quantify the range of beliefs of patients about their symptoms before consultation, and to test the hypothesis that patients who attribute symptoms to stress or lifestyle would expect less benefit than others from physical medicine but more from lifestyle change and emotional support. METHOD: Interviews with 100 patients attending one of two general practices were used to form a questionnaire, which was completed by 406 patients attending one of three general practices in contrasting areas of Greater London. This measured the frequency of specific beliefs about the causes of their symptoms and about effective forms of help. Patients were seen before their consultation. RESULTS: The most common aetiological beliefs concerned stress and lifestyle. In general, the mechanisms underlying symptoms were thought to be disturbances in bodily functioning rather than pathological processes. The most valued form of help was explanation and discussion of symptoms. Nevertheless, about half the patients expected benefit from medication and only slightly fewer from hospital investigation or treatment. Patients who attributed symptoms to stress or lifestyle were no less likely to expect help from medication or specialist referral, but they were more likely to see benefit in explanation and counselling or lifestyle change. CONCLUSIONS: These findings suggest hypotheses for future research into the effects that patients' attributions of their symptoms to stress and lifestyle have on their health care demands, emphasize the importance of routinely assessing patients' beliefs on consulting the GP, and provide information that can help to direct this assessment in the individual case.     

Beliefs about medicines and self-reported adherence among pharmacy clients

ObjectivesTo analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables.MethodsThe data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse).ResultsOf the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines.ConclusionsGeneral-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines.Practice implicationsIncreased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.     

Cancer patients' perceptions of positive and negative illness-related changes

We assessed perceived cancer-related change in 153 recently diagnosed patients. High levels of social support and optimism at the start of chemotherapy predicted higher numbers of perceived positive changes and lower numbers of negative changes nine months later. Higher numbers of perceived gains predicted an increase in positive affect, and higher numbers of negative changes predicted an increase in negative affect at follow-up. We conclude that finding positive consequences of cancer promotes psychological well-being, but patients with low levels of psychosocial resources are at risk for finding nothing beneficial in adversity.