Assuntos
Internação Compulsória de Doente Mental/legislação & jurisprudência , Motivação , Prevenção do Suicídio , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , Antidepressivos/uso terapêutico , Neoplasias Encefálicas/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Divórcio/psicologia , Ética Médica , Eutanásia/psicologia , Humanos , Linfoma Relacionado a AIDS/psicologia , Masculino , Alta do Paciente , Autonomia Pessoal , Psicoterapia , Medição de Risco , Papel do Doente , Suicídio/legislação & jurisprudência , Suicídio/psicologia , Suicídio Assistido/psicologia , Recusa do Paciente ao Tratamento/psicologiaRESUMO
PURPOSE: To determine whether interviewed non-Hodgkin's lymphoma (NHL) patients differed from non-interviewed NHL patients and to revise the population-based risk estimate for NHL associated with HIV infection in homosexual men in the San Francisco Bay Area. Differences between study participants and non-participants are a concern in epidemiologic studies. Recruitment techniques can be modified when nonparticipation is a result of subject refusal. However, the solutions for nonparticipation due to death are less clear, especially when rapid case ascertainment (RCA) is used to identify newly diagnosed patients. METHODS: A large population-based case-control study was conducted in the San Francisco Bay Area between 1988 and 1995 to investigate risk factors for NHL. Nearly 1600 patients were interviewed and included in this study. A total of 1047 NHL patients were not interviewed because they had died prior to contact (602 patients) or we had received their RCA information after the study had ended (445 patients). We compared available demographic, clinical, and histologic profiles of the interviewed and non-interviewed NHL patients. RESULTS: Compared with the interviewed group, the non-interviewed group was younger, had more single HIV-infected homosexual men and a higher incidence of high-grade and "not-otherwise-specified" lymphoma. When categorized by sex and sexual preference, median age at diagnosis of NHL was the same for the interviewed and non-interviewed homosexual men. Combining interviewed and non-interviewed patients, the estimated risk for NHL associated with HIV infection in homosexual men [odds ratio (OR) = 50] is substantially higher than we had estimated in our earlier publications (OR = 20). CONCLUSIONS: High-grade lymphomas associated with poor survival in homosexual men are likely to be under-represented in case-control studies of NHL.
Assuntos
Soropositividade para HIV/complicações , Linfoma não Hodgkin , Adulto , Idoso , Atitude Frente a Saúde , California/epidemiologia , Estudos de Casos e Controles , Feminino , Homossexualidade Masculina/psicologia , Humanos , Incidência , Linfoma Relacionado a AIDS/epidemiologia , Linfoma Relacionado a AIDS/etiologia , Linfoma Relacionado a AIDS/psicologia , Linfoma não Hodgkin/epidemiologia , Linfoma não Hodgkin/etiologia , Linfoma não Hodgkin/psicologia , Masculino , Pessoa de Meia-Idade , Prevalência , Projetos de Pesquisa , Fatores de Risco , Programa de SEER , São Francisco/epidemiologia , Viés de Seleção , Inquéritos e QuestionáriosRESUMO
HIV disease attacks people without regard to age, race, gender or socioeconomic status, and the number of people affected continues to increase. The increased incidence of disease and increased length of survival will lead to a rise in HIV-related CNS syndromes. CNS involvement adds to the complexity of the disease and necessitates involvement of many disciplines. The nurse is responsibility for facilitating and coordinating the multidisciplinary team effort. The nurse must also be an advocate to provide access to beneficial services and to develop services that are not in place. The task of nursing is to assist the person living with AIDS to maintain his or her quality of life however they wish to define it.
