Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention.

BACKGROUND: Exercise is associated with an improved quality of life among cancer survivors. Previous research has highlighted the utility of the theory of planned behavior in understanding cancer survivors' intention to exercise. The purpose of this study was to extend the research on the theory of planned behavior in relation to exercise intention in breast cancer survivors and to provide preliminary evidence supporting its application with prostate cancer survivors during treatment. METHODS: Participants consisted of 126 breast and 82 prostate cancer survivors receiving active treatment. Participants completed self-administered, mail-in questionnaires that assessed demographic and medical variables, past exercise, and the theory of planned behavior. RESULTS: For breast cancer survivors, the results revealed that attitudes, subjective norm, and perceived behavioral control explained 66% of the variance in exercise intention with the instrumental component of attitude, subjective norm, and perceived behavioral control making significant unique contributions to intention. For prostate cancer survivors, attitudes, subjective norm, and perceived behavioral control explained 57% of the variance in exercise intention, with subjective norm and perceived behavioral control making significant unique contributions to intention. CONCLUSIONS: The results provide further support that the theory of planned behavior is a useful framework for understanding determinants of exercise intention in breast cancer survivors undergoing active treatment and preliminary support for prostate cancer survivors undergoing active treatment. When designing exercise interventions, differences in breast and prostate cancer survivors' exercise intention merit consideration.

Burnout in clinical research coordinators in the United States.

PURPOSE/OBJECTIVES: To assess burnout among clinical research coordinators (CRCs) and to determine which personal and job-related factors are associated with burnout. DESIGN: Random, stratified, cross-sectional mail survey. SETTING: CRCs from membership lists of clinical research organizations. SAMPLE: 252 CRCs in the United States. To be included in the study, participants must have been in their current position longer than six months and involved in clinical trial coordination or data management. Of 2,770 records, 900 CRCs were mailed questionnaires; 35% (316) responded, and 252 of those were eligible for analysis. Eligible respondents were Caucasian (86%), female (94%), and employed full-time (92%) in an oncology setting (71%). METHODS: Respondents completed mailed self-administered questionnaires measuring burnout, job satisfaction, personality characteristics, perceived work overload, and selected personal- and employment-related data. Data analyses included descriptive, univariate, and multivariate statistics. MAIN RESEARCH VARIABLE: Burnout. FINDINGS: About 70% of respondents were satisfied with their job, and 74% would still choose the clinical research profession. Approximately 44% reported high emotional exhaustion, a component of burnout. Factors independently associated with high emotional exhaustion burnout were low satisfaction with job (p 0.0001), high perceived daily workload (p 0.0001), and low endurance personality (p = 0.002). CONCLUSIONS: Burnout is prevalent in CRCs. Job dissatisfaction, perceived daily work overload, low endurance, and nurturance personality traits were associated with high burnout. IMPLICATIONS FOR NURSING: Nurses are involved significantly in clinical trial coordination. High burnout rates have potentially negative implications for data quality and productivity in clinical trial data management-important values for nursing and the clinical research profession.

Assessing communication between oncology professionals and their patients.

BACKGROUND: Effective communication with cancer patients continues to be an elusive goal for health care professionals (HCPs) and cancer educators. METHODS: We posted a survey on the ConversationsInCare.com Web site to collect information from oncology HCPs regarding attitudes, effectiveness, and specific patient communication skills. RESULTS: The 291 respondents agreed that good communication enhances patient satisfaction (76%) and treatment compliance (88%). Only 34% of respondents felt comfortable discussing complementary or alternative therapies, and approximately half of all respondents felt they lack the skills to help patients maintain hope. CONCLUSIONS: Oncology HCPs believe that good communication is important and wish to improve their skills. Implications for cancer educators are discussed.

Patient-physician communication regarding use of complementary therapies during cancer treatment.

It is estimated that as many as 80% of adult cancer patients use at least one form of Complementary and Alternative Medicine (CAM) during or after conventional treatment. Studies of physician-patient communication about the use of CAM have concluded that patients frequently do not tell their oncologists about their use of CAM and physicians consistently underestimate the numbers of their patients using CAM. The purpose of this multi-site study was to assess newly diagnosed cancer patients' and oncologists' communication practices with regard to complementary therapies. Patients (106 breast and 82 prostate) indicated which of 45 complementary therapies they were using while physicians at their institutions indicated which they supported. It is noted that, although we use the popular acronym "CAM" all patients surveyed were receiving conventional medical treatment. Thus, the survey addressed complementary therapies only. A large majority (84%) indicated they were using at least one therapy with the most popular being exercise, vitamins, prayer, and nutritional supplements. Surprisingly, the oncologists surveyed were generally enthusiastic and supportive of patients' use of complementary therapies. In addition to those therapies popular with patients, at least half the physicians supported massage, journal writing, support groups, acupuncture, biofeedback, and art therapy. However, discussions of CAM are relatively rare and most likely to be initiated by patients. When the topic is discussed, both patients and doctors say it usually enhances their relationship. Implications for CAM program development and oncology professionals' roles in patient education regarding complementary therapies are presented.

Toward Understanding Women Who Request Removal of Silicone Breast Implants.

Fifty-five women were surveyed prior to explantation of their silicone breast implants regarding their reasons for having implants and their reasons for wanting them removed. Open-ended questions were used and content analysis was done to identify themes in their responses. Most of the women had implants for cosmetic reasons, with 28% having them for breast reconstruction after mastectomy. About one-third were actively or passively encouraged by their male partners, while nearly the same number reported they were influenced primarily by female friends or relatives. Regarding reasons for removal, the most commonly cited reasons were breast health problems (implants ruptured, painful or uncomfortable) cited by 59%, general health problems (48%), diagnosed with connective tissue disease (25%), and concern about long-term effects of silicone (18%). Some women blamed a broad array of health problems on the implants, and a few were angry about being given bland reassurances about the safety of the devices. However, the majority were uncertain about the role of silicone in their overall health but were hopeful that removal would restore their health and end their worries about long-term effects. The average subject was 34 years old when she had the implants to feel more attractive. Now she is 44 and more concerned about her health and her family than her physical appearance.