Patient delay to diagnosis and its predictors among colorectal cancer patients: A cross-sectional study based on the Theory of Planned Behavior.

PURPOSE: The prognosis for colorectal cancer is closely related to the time of diagnosis. However, patient delay is common and become a major contributor to delays in cancer diagnosis. We aimed to investigate patient delay and its predictors based on the Theory of Planned Behavior among colorectal cancer patients. METHODS: In total, 303 colorectal cancer patients were recruited from a Grade-A tertiary cancer center in southern China by convenience sampling. The participants' general information, stigma, self-efficacy, and knowledge about colorectal cancer were assessed by a self-designed general information questionnaire, the Social Impact Scale, the General Self-Efficacy Scale, and the section of the Bowel Cancer Awareness Measure on total knowledge of colorectal cancer. Descriptive statistics, univariate analysis, and binary logistic regression were applied for data analysis. RESULTS: The median patient delay was four months (range: 1 day-10 years). The prevalence of prolonged patient delay (≥3 months) was 57.8%. Identified by binary logistic regression, prolonged patient delay was associated with having no close family members/friends in medical professionals, unwillingness to accept colonoscopy, blood in stools, dyspepsia, insufficient support from family members, more measures taken to control symptoms, lower perceived severity of symptoms, knowledge shortage, negative help-seeking attitudes, lower self-efficacy, and higher stigma. CONCLUSIONS: Patient delay was considerable in individuals with colorectal cancer in China. Factors associated with patient delay are complex in Chinese culture. To shorten patient delay, culturally sensitive interventions may be required to improve knowledge, alleviate cancer stigma, enhance self-efficacy to seek medical attention, and promote positive help-seeking behaviors.

[The effect of yoga exercise intervention on health related physical fitness in school-age asthmatic children].

The purpose of this study was to investigate the effect of yoga exercise on the health-related physical fitness of school-age children with asthma. The study employed a quasi-experimental research design in which 31 voluntary children (exercise group 16; control group15) aged 7 to 12 years were purposively sampled from one public elementary school in Taipei County. The yoga exercise program was practiced by the exercise group three times per week for a consecutive 7 week period. Each 60-minute yoga session included 10 minutes of warm-up and breathing exercises, 40 minutes of yoga postures, and 10 minutes of cool down exercises. Fitness scores were assessed at pre-exercise (baseline) and at the seventh and ninth week after intervention completion. A total of 30 subjects (exercise group 16; control group 14) completed follow-up. Results included: 1. Compared with children in the general population, the study subjects (n = 30) all fell below the 50th percentile in all five physical fitness items of interest. There was no significant difference in scores between the two groups at baseline (i.e., pre-exercise) for all five fitness items. 2. Research found a positive association between exercise habit after school and muscular strength and endurance among asthmatic children. 3. Compared to the control group, the exercise group showed favorable outcomes in terms of flexibility and muscular endurance. Such favorable outcomes remained evident even after adjusting for age, duration of disease and steroid use, values for which were unequally distributed between the two groups at baseline. 4. There was a tendency for all item-specific fitness scores to increase over time in the exercise group. The GEE analysis showed that yoga exercise indeed improved BMI, flexibility, and muscular endurance. After 2 weeks of self-practice at home, yoga exercise continued to improve BMI, flexibility, muscular strength, and cardiopulmonary fitness.