ABSTRACT
The Consultation and Relational Empathy (CARE) Measure (Mercer et al., 2004) is a patient-rated experience measure of practitioner empathy, developed and validated within adult health services. This study reports the feasibility, acceptability, reliability and validity of three adapted versions of the original CARE measure for the paediatric setting, namely the Visual CARE Measure 5Q, 10Q and 10Q Parent (also known as the Paediatric CARE Measure). Three hundred and sixty-nine participants (N = 149 children (40%) and N = 220 parents (60%)) completed the measure following consultation with an Allied Health Professional (AHP). AHPs felt it was feasible to use the measure in routine practice and the majority of children and parents found the measure easy to understand (98%) and complete (98%). Internal reliability (Cronbach's α) was .746 for the 5Q, .926 for the 10Q and .963 for the 10Q parent. Few participants used the 'not applicable' response (N = 28 (8%)), suggesting high content validity. AHPs found the measures relevant (95%) and useful (90%) and reported that they were likely to use them again (96%). The Visual CARE Measure shows promise as a useful tool to enable children and their parents to give their views. Further research on the tool's reliability and validity is required.
Subject(s)
Allied Health Personnel , Empathy , Parents , Physician-Patient Relations , Adolescent , Child , Child, Preschool , Feasibility Studies , Female , Humans , Infant , Infant, Newborn , Male , Patient-Centered Care , Professional-Family Relations , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
OBJECTIVES: Men's response to ill health is framed as a "battleground" for the enactment of masculinities. With an increase in diagnoses of men's cancers, there is a need to better understand the features which influence timely access to diagnostic services. This study explored the ways in which men account for the timing of their diagnosis of prostate cancer. METHODS: Thirty semi-structured interviews were conducted with men and, where possible, their partner. Data were analyzed with reference to framework analysis. RESULTS: Relationships, including spousal, familial, and friendships, appear pivotal in informing men's help-seeking behaviors. Friends and partners were often critical in facilitating access to primary care. Following their own diagnosis, this virtuous cycle of encouragement led many men to encourage others to seek medical attention for prostate tests. CONCLUSIONS: Interpersonal relationships are a missing dimension in models of delay. We need to know more about how to use relationships, in addition to traditional routes, to harness health promotion messages. Interpersonal relationship, including partners and social networks, may be powerful conduits and may prove effective mechanisms to identify and access men most at risk of prostate cancer.
Subject(s)
Interpersonal Relations , Masculinity , Patient Acceptance of Health Care/psychology , Primary Health Care , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/psychology , Aged , Family , Health Promotion , Health Services Needs and Demand , Humans , Male , Middle Aged , Qualitative Research , Sexual PartnersABSTRACT
UNLABELLED: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Prostate cancer has three known clinical risk factors: age, ethnicity and family history. Men's knowledge of prostate cancer is low. This study demonstrates that men rely on family and friends to learn about prostate cancer and help them interpret their risk. The findings suggest the need for tailored prostate cancer education, through social networks, to encourage risk-stratified PSA testing, which will lead to earlier diagnosis for those most at risk. OBJECTIVES: To determine men's perceptions of their risk of developing prostate cancer. To consider the implications for PSA testing based on individual risk perceptions. PATIENTS AND METHODS: The research adopted an embedded mixed-method design, using clinical records and a retrospective postal survey. Patients (N = 474) diagnosed with prostate cancer in a two-year period (2008-2009) in Greater Glasgow were identified from pathology records. In all, 458 men received a postal survey (16 deceased patients were excluded); 320 men responded (70%). RESULTS: Analysis indicates that there is no association between known clinical risk factors and men's perceptions of their own risk. Older men did not display increased perceived risk. Men with a family history of prostate cancer (11%) had no increase in their own perception of risk. PSA tests are not requested by those who are at greater risk. The subsample of patients who had requested a test were no more likely to have a family history of prostate cancer. They were more likely, however, to perceive themselves to be at high risk, to have friends with prostate cancer, to be affluent and to have a low grade tumour. CONCLUSIONS: GPs need to balance men's risk perceptions in discussions about known clinical risk factors. Men's knowledge of prostate cancer stems largely from interpersonal sources (such as friends/family). Social networks may consequently offer an additional opportunity to increase awareness of risk-stratified testing.
