RESUMO
Patient-reported benefits of research participation have been described by study participants; however, many studies have small sample sizes or are limited to patient groups with poor prognoses. The purpose of this study was to explore the effects of research participation on patient experience using survey responses from a large, national sample of cancer patients (N = 66 462) and interviews with breast cancer patients attending a London trust. Multivariate logistic regression was used to investigate associations between taking part in research and positive patient experience. Based on our analysis, patients who participated in research were more likely to rate their overall care and treatment as 'very good/excellent' (ORadj :1.64, 95%CI: 1.53-1.76, P < 0.001) and to describe positive patient experiences, such as better access to non-standard care, better interactions with staff and being treated as an individual. However, findings from our interviews indicated that there was no common understanding of what constitutes cancer research and no clear delineation between research participation and standard care, from the patient perspective. Further work to explore how participation positively influences patient experience would be useful to develop strategies to improve care and treatment for all patients regardless of whether or not they choose, or have the opportunity, to take part in research.
Assuntos
Neoplasias da Mama/terapia , Participação do Paciente , Pesquisadores , Adulto , Idoso , Neoplasias da Mama/psicologia , Ensaios Clínicos como Assunto/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Satisfação do Paciente , Relações Profissional-PacienteRESUMO
BACKGROUND: Increasingly studies show that immigrants have different perinatal health outcomes compared to native-born women. Nevertheless, we lack a detailed examination of the combined effects of maternal immigrant trajectory and socioeconomic status on perinatal outcomes. Our objective was to analyze the influence of time since naturalization on low birth weight and maternal socioeconomic status in Belgium. METHODS: The data came from the linkage between the Brussels birth and death registers, the national register of migrant trajectories and the social security register for the years 2004-2010. We used logistic regression to estimate the odds ratios of the associations between low birth weight (LBW) and time since naturalization, by nationality groups, taking into account socioeconomic status (SES), parity and maternal age. RESULTS: Data relate to all singleton births to Belgian, Maghrebi, Sub-Saharan African and Turkish women (n = 76 312). The results show an U-shaped of LBW according to time since naturalization for all migrant groups. LBW declines for women naturalized since less than one year and increases significantly thereafter (p<0.0001). In parallel, we observe an increase of SES among all migrant groups. Compared to Belgians, we found a lower risk of LBW among women from Maghreb (p<0.0001) and this protection is maintained even after 10 years since naturalization. In contrast, the risk of LBW for Sub-Saharan African and Turkish mothers is lower than for Belgians after one year of naturalization but similar to that of Belgians after 10 years of naturalization. CONCLUSION: Our results show that, despite an improvement of their SES, LBW increases among Maghrebi, Sub-Saharan African and Turkish women with time since naturalization. Mothers from Maghreb have lower rates of LBW compared to Belgians and maintain their protection even after more than 10 years of having acquired the Belgian nationality. Additional studies need to be carried out in order to gain a better understanding of the association between migration trajectories, SES and perinatal health of immigrants.
Assuntos
Emigrantes e Imigrantes , Recém-Nascido de Baixo Peso , África do Norte , Bélgica , Feminino , Humanos , Recém-Nascido , Mães , Gravidez , Resultado da Gravidez , Sistema de Registros , Classe Social , Fatores de TempoAssuntos
Estatura , Índice de Massa Corporal , Peso Corporal , Autoavaliação Diagnóstica , Obesidade/mortalidade , Feminino , Humanos , MasculinoRESUMO
About 43 percent of U.S. adults--76 million people--have been exposed to alcoholism in the family: they grew up with or married an alcoholic or a problem drinker or had a blood relative who was ever an alcoholic or problem drinker. Exposure was higher among women (46.2 percent) than among men (38.9 percent) and declined with age. Exposure to alcoholism in the family was strongly related to marital status, independent of age: 55.5 percent of separated or divorced adults had been exposed to alcoholism in some family member, compared with 43.5 percent of married, 38.5 percent of never married, and 35.5 percent of widowed persons. Nearly 38 percent of separated or divorced women had been married to an alcoholic, but only about 12 percent of currently married women were married to an alcoholic. These findings are highlights of an analysis of the 1988 National Health Interview Survey on Alcohol that is presented in this report.
Assuntos
Alcoolismo/epidemiologia , Saúde da Família , Inquéritos Epidemiológicos , Adulto , Idoso , Estudos de Avaliação como Assunto , Feminino , Gastos em Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , National Institutes of Health (U.S.) , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
The data presented in this report show that developmental, learning, and behavioral disorders are among the most prevalent chronic conditions of childhood and adolescence. Overall, nearly 20 percent of young people ages 3-17 years were found to have had one or more of these conditions. By the time they reached ages 12-17 years, 1 in 4 adolescents, and nearly 3 in 10 male adolescents, had experienced one of these disorders. When very young children with developmental delays were included, the total number of U.S. children affected came to about 10.7 million. As high as these figures may seem, it is altogether possible that they are underestimates of the true prevalence of the conditions. The only childhood disorders counted in NHIS-CH were those that had been recognized by parents or identified by physicians, psychologists, or teachers and communicated to parents with sufficient clarity that the parents were able to report them to survey interviewers. There is reason to believe that some developmental, learning, and emotional disorders of children are not recognized as such, or the assessment of teachers or health professionals are not understood or not accepted by parents. Confusion over changing diagnostic terminology and simple forgetting of problems that occurred in the past probably work to reduce the reporting of these conditions as well. Despite the limitations of parental reporting, it is useful to have data on the prevalence of psychological disorders in young people based on standard survey questions put to the parents of a large and nationally representative sample of children. Estimates derived from NHIS-CH provide national benchmarks on the overall frequency of recognized psychological disorders in children and on the relative frequency of such problems in different population groups. The findings with regard to overall prevalence were that 4.0 percent of all children 17 years of age and under had delays in growth or development, 6.5 percent of children ages 3-17 years had learning disabilities, and 13.4 percent had significant emotional or behavioral problems. The proportions of all children ages 3-17 years who had ever received treatment or counseling for the conditions were about 2 percent for developmental delays, just over 5 percent for learning disabilities, and more than 10 percent for emotional or behavioral problems. These proportions fall within the range of prevalence estimates that have appeared in the literature.(ABSTRACT TRUNCATED AT 400 WORDS)
Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Serviços de Saúde da Criança/estatística & dados numéricos , Deficiências do Desenvolvimento/epidemiologia , Inquéritos Epidemiológicos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Deficiências da Aprendizagem/epidemiologia , Masculino , Prevalência , Estados Unidos/epidemiologiaRESUMO
In 1992, levels of knowledge about the major modes of human immunodeficiency (HIV) transmission remained high in all sociodemographic groups examined. Knowledge about other aspects of acquired immunodeficiency syndrome (AIDS) was more variable with older and less educated adults generally being less knowledgeable. Changes in knowledge between 1991 and 1992 included: An increase from 86 to 95 percent in the proportion who had heard the AIDS virus referred to as "HIV" An increase from 15 to 22 percent in the proportion of young adults (18-29 years of age) who planned to be tested in the next year An increase from 13 to 17 percent in the proportion of adults who had a coworker, relative, or friend with AIDS An increase from 69 to 75 percent in the proportion of parents of 10-17-year-olds who had ever discussed AIDS with their children.
Assuntos
Síndrome da Imunodeficiência Adquirida/transmissão , Educação em Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Síndrome da Imunodeficiência Adquirida/prevenção & controle , Adolescente , Adulto , Negro ou Afro-Americano , Idoso , Escolaridade , Feminino , Pesquisa sobre Serviços de Saúde , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , National Center for Health Statistics, U.S. , Projetos de Pesquisa , Inquéritos e Questionários , Estados Unidos , População BrancaRESUMO
The health status of immigrants is of vital interest to health policy planners as the number of immigrants in the United States increases. This report has shown that, overall, foreign-born persons had better health than the U.S.-born population, although this health advantage varied by length of residence in the United States. In virtually every measure of health status, and with regard to almost every sociodemographic characteristic, the most recent immigrants were healthier than foreign-born persons who have lived in the United States 10 years or more as well as healthier than the U.S.-born population. Immigrants who had lived in the United States 10 years or longer were generally healthier than U.S.-born adults, although the differences were not as striking as between recent immigrants and the native-born population. These findings may be explained in several ways. First, recent cohorts of immigrants may have been healthier than earlier cohorts of immigrants at the time of immigration. If so, as their duration of residence in the United States increases, they will continue to be significantly healthier than native-born persons. Second, earlier cohorts of immigrants may have been as healthy as recent cohorts at the time of immigration, but their health has deteriorated with increased duration of residence in the United States. This suggests that immigrants had or acquired physical conditions or behaviors that put them at risk in their new environment or that access to health care has been limited. It also suggests that more recent cohorts of immigrants could experience a similar deterioration of health as their duration of residence in the United States increases. Finally, these findings may reflect a combination of these influences or other factors not considered. To understand these patterns will require additional research, including comparative studies of the health of immigrants in the United States with the health of nonmigrants (stayers) in the countries of immigrant origin.
Assuntos
Emigração e Imigração/estatística & dados numéricos , Nível de Saúde , Grupos Minoritários/estatística & dados numéricos , Adolescente , Adulto , Idoso , Coleta de Dados , Demografia , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Médicos/estatística & dados numéricos , Estados Unidos/epidemiologiaRESUMO
The major significance of the current report is that it provides estimates and characteristics for that portion of the civilian SMI population living in households. Survey results show that approximately 3.3 million adult Americans have mental disorders that seriously interfere with one or more aspects of daily life and that about 2.6 million of these persons are currently limited in one or more functional areas. These results suggest that the household component of the SMI population is comprised of between 2.6 and 3.3 million adults, depending upon the criteria employed for inclusion. Undoubtedly, both of these numbers are conservative because of the likelihood of underreporting in the survey. Placed in the context of the entire adult population, these findings suggest that the SMI population can be conservatively estimated to include 4 to 5 million adult Americans, or 2.1 to 2.6 øpercent of the adult population. In addition to the household population, it is estimated that 200,000 SMI persons are homeless on any given day (13). An additional 1 million to 1.1 million are residents of nursing homes (14), approximately 50,000 to 60,000 are patients of mental hospitals, and approximately 50,000 are inmates of State prisons (15). A major remaining need is to collect similar data on all SMI persons, whether their residence is a household, an institutional or noninstitutional group quarter, or some other setting, including streets and shelters. In order to formulate more effective national policy to address the needs of these disabled Americans, a need exists to examine the longitudinal relationship between course of disorder and functioning as they relate to service and program participation.
Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Deficiência Intelectual/epidemiologia , Transtornos Mentais/epidemiologia , Adulto , Idoso , Desinstitucionalização , Prescrições de Medicamentos/estatística & dados numéricos , Emprego/estatística & dados numéricos , Feminino , Humanos , Deficiência Intelectual/economia , Entrevistas como Assunto , Masculino , Assistência Médica/estatística & dados numéricos , Transtornos Mentais/economia , Serviços de Saúde Mental/economia , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Pobreza/estatística & dados numéricos , Projetos de Pesquisa , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
This report presents national estimates of the prevalence of selected health risk behaviors among youth ages 12-21 years, by sex, Hispanic origin, and race for youth of non-Hispanic origin. Topics include: cigarette and other tobacco use, alcohol and other drug use, sexual experience, HIV/AIDS education, runaway and homeless experiences, violence, unintentional injury control, weight control, and participation in physical activities. Data are from the 1992 National Health Interview Survey's Youth Risk Behavior Survey.
Assuntos
Comportamento do Adolescente , Comportamentos Relacionados com a Saúde , Assunção de Riscos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas , Demografia , Etnicidade , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Humanos , Masculino , Vigilância da População , Comportamento Sexual , Fumar , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos/epidemiologia , ViolênciaRESUMO
STUDY OBJECTIVE: The aims were: (1) to identify methodological problems that may explain the inconsistencies and contradictions in the research evidence on social support and health, and (2) to validate a frequently used measure of social support in order to determine whether or not it could be used in multivariate analyses of population data in research on social support and health. DESIGN AND METHODS: Secondary analysis of data collected in a cross sectional survey of a multistage cluster sample of the population of the United States, designed to study relationships in behavioural, social support and health variables. Statistical models based on item response theory and graph theory were used to validate the measure of social support to be used in subsequent analyses. PARTICIPANTS: Data on 1755 men and women aged 20 to 64 years were available for the scale validation. RESULTS: Massive evidence of item bias was found for all items of a group membership subscale. The most serious problems were found in relationship to an item measuring membership in work related groups. Using that item in the social network scale in multivariate analyses would distort findings on the statistical effects of education, employment status, and household income. Evidence of item bias was also found for a sociability subscale. When marital status was included to create what is called an intimate contacts subscale, the confounding grew worse. CONCLUSIONS: The composite measure of social network is not valid and would seriously distort the findings of analyses attempting to study relationships between the index and other variables. The findings show that valid measurement is a methodological issue that must be addressed in scientific research on population health.
Assuntos
Pesquisa sobre Serviços de Saúde/métodos , Nível de Saúde , Apoio Social , Adulto , Fatores de Confusão Epidemiológicos , Estudos Transversais , Escolaridade , Emprego , Métodos Epidemiológicos , Feminino , Humanos , Renda , Masculino , Estado Civil , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estados UnidosRESUMO
Seven health habits, commonly referred to as the "Alameda 7," were shown to be associated with physical health status and mortality in a pioneer longitudinal study initiated in 1965 in Alameda County, CA. These habits are having never smoked, drinking less than five drinks at one sitting, sleeping 7-8 hours a night, exercising, maintaining desirable weight for height, avoiding snacks, and eating breakfast regularly. The Alameda study focused attention on the importance of everyday practices for the maintenance of good health and, ultimately, for longer life. This report presents selected findings on the prevalence of the seven Alameda practices (defined slightly differently in some cases) among the general U.S. population aged 18 years and older, by sex, according to age, education, income, and race. In general, men are more likely than women to smoke, drink, and exercise. Younger people are more likely than older people to skip breakfast, snack, and drink, and younger women are more likely than older women to smoke. Education, income, and racial differences were found for most health practices. Of all subgroups discussed, blacks, particularly black women, are the most likely to have lifestyles that would be considered unhealthy using the Alameda criteria. Overall, the data reported suggest that although large numbers of U.S. adults have healthy habits, many do not, particularly persons in socially and economically disadvantaged groups.
Assuntos
Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Estilo de Vida , Mortalidade , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Peso Corporal , Comportamento Alimentar , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Esforço Físico , Sono , Fumar , Estados UnidosAssuntos
Alcoolismo/epidemiologia , Promoção da Saúde , Transtornos do Humor/complicações , Fumar/epidemiologia , Alcoolismo/prevenção & controle , Alcoolismo/psicologia , Causalidade , Comorbidade , Coleta de Dados , Feminino , Humanos , Masculino , Saúde Mental , Transtornos do Humor/epidemiologia , Razão de Chances , Fumar/psicologia , Prevenção do Hábito de Fumar , Estados Unidos/epidemiologiaAssuntos
Comportamentos Relacionados com a Saúde , Fumar/epidemiologia , Adolescente , Adulto , Dieta , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Fumar/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Estados Unidos/epidemiologia , Violência/psicologia , Violência/estatística & dados numéricosAssuntos
Cocaína/efeitos adversos , Indicadores Básicos de Saúde , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Atividades Cotidianas , Adolescente , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Abuso de Maconha/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Estados Unidos/epidemiologiaAssuntos
Promoção da Saúde , Medicina Preventiva , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Gravidez , Estados UnidosAssuntos
Tabagismo/epidemiologia , Adolescente , Adulto , Idoso , Atitude Frente a Saúde , Feminino , Comportamentos Relacionados com a Saúde , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , National Center for Health Statistics, U.S. , Prevalência , Condições Sociais , Tabagismo/etiologia , Tabagismo/psicologia , Estados Unidos/epidemiologia , Estatísticas VitaisRESUMO
The prevalence levels of 12 health practices in the United States and Canada are compared in this study: smoking; drinking status; average daily alcohol consumption; physical activity; eating breakfast; use of seatbelts and child safety restraints; ownership of smoke detectors; recency of blood pressure checks, breast examinations, and Pap tests; and practice of breast self-examination. Data for two additional variables--drinking and driving and blood pressure awareness--are shown for the two countries, but the statistics cannot be strictly compared. Data are presented for four age groups by sex and for three levels of education. Trends in smoking and seatbelt use between 1979 and 1985 are also discussed.