RESUMO
To examine knowledge and attitudes about lung health promotion (smoking cessation and lung cancer screening) among Black male smokers in a large Midwestern city in the United States. Semi-structured, in-depth interviews were conducted with 25 study participants. Each interview lasted approximately 45 minutes. Participants also completed a brief (5-10 minutes) survey measuring demographic characteristics, smoking experiences and knowledge and attitudes about lung health promotion activities. Descriptive statistics were used for quantitative data, and deductive thematic analysis for qualitative data analysis. The mean age of study participants was 57.5 years. Eighty-four percent of participants were current smokers, with the majority being daily smokers. Perceived risk for lung cancer was mixed, with 56% of participants endorsing that they considered themselves to be at high or moderate risk and the remaining 44% at low or no risk for lung cancer. Forty percent of participants reported having had a test to check their lungs for cancer. Participants were aware of the health risks associated with smoking but reported limited assistance from providers regarding the receipt of smoking cessation treatments. Awareness of lung cancer screening was limited, but participants expressed openness to screening; however, barriers were anticipated, including costs, fear and a reduced willingness to be screened in the absence of symptoms. Study participants reported limited experiences with lung health promotion activities. Knowledge about the facilitators and barriers can be used to develop health promotion interventions targeting smoking cessation and lung cancer screening.
RESUMO
The study's goal was to look at providers' knowledge, attitudes, and behaviors regarding lung cancer screening among Black male smokers served by a federally qualified healthcare center. Participants in the study were interviewed in depth. Participants completed a short (5-10 minute) survey that assessed demographics, training, and attitudes toward lung cancer screening. For quantitative data, descriptive statistics were used, and for qualitative data, deductive thematic analysis was used. This study included ten healthcare professionals, the majority of whom identified as Black (80%) and were trained as advanced practice providers (60%). The majority of providers (90%) have heard of LDCT lung cancer screening; however, participants reported only being "somewhat" familiar with the LDCT eligibility criteria (70%). Despite generally positive attitudes toward LDCT, patient referral rates for screening were low. Barriers included a lack of provider knowledge about screening eligibility, a lack of use of shared decision-making tools, and patient concerns about screening risks. The reasons for the low referral rates varied, but they included a preference to refer patients for smoking cessation rather than screening, low screening completion and follow-up rates among referred patients, and a lower likelihood that Black smokers will meet pack-year requirements for screening. Additionally, providers discussed patient-level factors such as a lack of information, mistrust, and transportation. The study findings add to the body of knowledge about lung cancer knowledge and screening practices among providers in FQHC settings. This data can be used to create health promotion interventions aimed at smoking cessation and lung cancer screening in Black males and other high-risk smokers.
RESUMO
Medication non-adherence is a leading cause of poor treatment outcomes among Thai patients with psychiatric disorders and creates challenges for psychiatric nurses. This systematic review synthesized research on intervention effectiveness for antipsychotic medication adherence in Thai schizophrenic populations. Following PRISMA guidelines, searches were completed in seven databases, including PubMed, PsycINFO, CINAHL, Web of Science, Scopus, ThaiJO, and Google Scholar. No restriction dates were used. Screening and extraction of data were performed systematically. Eligible studies consisted of nine quasi-experimental and two randomized control trial studies. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used to assess the studies' methodological quality. This review revealed that individual counseling combined with cognitive-behavioral therapy (CBT) and motivational interviewing (MI) techniques improved and maintained medication adherence behavior over time. Post-testing after intervention completion and at 3- and 6-month follow-ups showed that treatment group participants were more adherent than control group participants (p < 0.01). These findings suggest that incorporating CBT and MI into clinical practice can enhance medication adherence behavior. Booster session efficacy for reinforcing and sustaining adherence should be investigated. Greater rigor is warranted in future intervention studies based on a quality appraisal of previous studies.