Urban black women's perceptions of breast cancer and mammography.

The purpose of this study was to examine differences in perceptions of breast cancer and mammography between black women who wanted a mammogram and those who did not. The subjects were 186 low socioeconomic black women who attended an inner city community health clinic (83% response rate). There were no significant differences on the demographic and background variables between women who did (N = 139) and did not (N = 47) want a mammogram. The knowledge level of both groups regarding breast cancer was poor. Those who desired a mammogram perceived themselves as more susceptible to breast cancer, and considered breast cancer more severe than those who did not want a mammogram. Neither group identified many barriers to obtaining a mammogram. The majority (at least 88 percent of those who wanted a mammogram and at least 55 percent of those who did not) agreed with each of the five benefit items. Eighty-five percent of both groups agreed they would receive a mammogram if their physician told them to do so. The two Health Belief Model components which accounted for the largest percentage of the variance between women who wanted a mammogram and those who did not were perceived benefits (13 percent) and perceived susceptibility (3 percent).

Cancer anxiety and attitudes toward mammography among screening attenders, nonattenders, and women never invited.

A mailed questionnaire survey was conducted among the following groups: 179 women who screened false positive at a free mammography screening; a random sample of 250 women who screened negative; 670 nonattenders of the screening; and a random population sample of 250 women who lived in another city and were not invited, but were otherwise comparable. The most frequently reported reason for nonattendance was not having the opportunity. Furthermore, only 18% of the nonattenders reported anxiety about breast cancer compared with 33% of the population sample (P less than .05). Ninety-nine percent of the women who attended indicated a positive attitude toward mammography that had not been adversely affected by screening experiences.

Relationships among burnout, death anxiety, and social support in hospice and critical care nurses.

The present study was undertaken to compare the occupational stress, levels of burnout, death anxiety, and the social support of a national sample of 376 hospice and critical care nurses. t tests indicated that critical care nurses reported significantly more occupational stress, showed higher burnout, and experienced more death anxiety than hospice nurses. The two nursing groups differed significantly when the three components of the Maslach Burnout Inventory were compared: hospice nurses reported feeling less emotional exhaustion, utilized the technique of depersonalization less frequently, and experienced a greater sense of personal accomplishment. The two nursing groups did not differ in social support when both the quantity and quality of that construct were examined. Pearson coefficients indicated positive associations between burnout and occupational stress and between burnout and death anxiety, with a negative relationship between burnout and social support.

Quality of life following a false positive mammogram.

To assess how women regard having had a false positive mammogram screening exam, and the influence that this had on their quality of life, 126 such women were interviewed. Their responses were compared to those of 152 women randomly selected among screenees with a negative exam. Eighteen months after the screening the reported prevalence of anxiety about breast cancer was 29% among women with a false positive and 13% among women with a negative screening mammogram (P = 0.001). Of 30 women biopsied, 8 (27%) had pain in the breast and 10 (33%) had reduced sexual sensitivity. A false positive mammogram was described by 7 (5%) of the women as the worst thing they ever had experienced. However, most women with a false positive result regarded this experience, in retrospect, as but one of many minor stressful experiences creating a temporary decrease in quality of life. They report the same quality of life today as women with negative screening results and 98% would attend another screening. Even so, false positive results are a matter of concern, and efforts should be made to minimise this cost whenever a screening programme is conducted.

Attitudes, beliefs, and knowledge about mammography among women over forty years of age.

In this study, the relative impact of health beliefs and physician request in predicting previous mammography experience among women over age 40 was examined. Responses from a sample of 201 women were analyzed using multiple regression techniques. The variable that accounted for the largest proportion (56%) of variance between women who had a mammogram or intended to and those who had not had the test and did not intend to was physician request for mammography. Women's perceptions about the benefits of mammography and perceived barriers were also significant, but the relative strength of these variables was low. Among women who had been asked by a physician to have a mammogram, 89.6% had done so, while only 10.4% of women who had not been asked to have a mammogram had done so. Implications for cancer education are discussed.

Public perceptions and behaviors regarding cancer control.

A random digit dialing method was used to select a stratified random sample of 413 residents from 5 counties in Northwest Ohio for the purpose of assessing public perceptions and behaviors regarding cancer. A fatalistic attitude was expressed by 46% of respondents, who agreed that it seems that almost everything causes cancer. Twenty-four percent agreed that one can do little to prevent cancer. Respondents expressed greater concern with cancer than with several major diseases, including AIDS (acquired immune deficiency syndrome). Eighty percent of females and 74% of males favored smoking restrictions in work areas, and 62% of females and 52% of males favored a total smoking ban in work areas. The majority of respondents reported having made some health protective behavior changes in the last year, but reported use of cancer screening procedures was low. A relationship was found between confidence in media reports about causes of cancer and a fatalistic attitude about cancer. Implications for public education about cancer are discussed.

Increasing physicians' and nurses' compliance with treatment guidelines in cancer care program.

Three community hospitals in Toledo, Ohio, formed a consortium with the common goal of improving the quality of cancer care in the community. Procedural guidelines were established for physicians, nurses, and allied health professionals to use in the diagnosis and treatment of 19 types of cancer. In this paper, the authors report the effect of the use of the guidelines on the care of patients with breast, colon, and non-small-cell lung cancers. Audits of patient records revealed an increase over time in the percentage of recommended cancer care procedures that were complied with. Factors that may have contributed to this success included the hospitals' commitments to the program at the professional and administrative levels, the ready availability of the guidelines during the treatment process, and a mandatory component requiring documented classification of the stage of the cancer.

Health locus of control of joggers and nonexercisers.

To gain a better understanding of why some people engage in regular leisure-time physical exercise while others remain sedentary, the Multidimensional Health Locus of Control scale was distributed to 123 younger joggers and 93 nonexercisers. Analysis of the responses indicated that the joggers scored significantly higher on the internal subscale than did the nonexercisers. No significant differences were found on the Chance and Powerful Others subscales. The disparity of these results from those of other studies of the relationship between locus of control and exercise suggest that an exercise specific locus of control scale needs to be developed. The confound of age with exercise and locus of control requires clarification.