Cancer survivors information seeking behaviors: a comparison of survivors who do and do not seek information about cancer.

OBJECTIVE: To examine the cancer information seeking behaviors and preferences of cancer survivors. METHODS: This cross-sectional study used the National Cancer Institute's 2003 Health Information National Trends Survey data to evaluate 619 cancer survivors. RESULTS: Two-thirds (67.5%, n = 418) of the survivors sought cancer information (InfoSeek) and 32.5% (n = 201) did not (NoInfoSeek). Significant predictors of cancer information seeking included age (less than 65), gender (female), income (>US$ 25,000/year), and having a regular health care provider (HCP). CONCLUSION: Not all survivors actively look for cancer information. Although most survivors prefer receiving cancer information from their HCP, many turn to a variety of other sources, primarily the Internet. PRACTICE IMPLICATIONS: HCPs should periodically assess information seeking behaviors and preferences of cancer survivors and actively refer patients to the Internet as an extension of and enhancement to their patient interactions. Credible and useful websites could be identified and recommended by the HCP as a means to address some of the barriers identified by survivors.

Patient and injury characteristics in abusive abdominal injuries.

OBJECTIVE: To identify patient and injury characteristics associated with suspected child abuse in the setting of blunt abdominal trauma. PATIENTS: We extracted from the National Pediatric Trauma Registry phases 2 and 3 (October 1995 to April 2001; N = 106,135) all cases of blunt abdominal injury, excluding motor vehicle injuries, in patients aged 0 to 4 years. MAIN OUTCOME MEASURES: Independent variables included age, mortality, nutritional status, and injury type. The dependent variable was suspected child abuse. RESULTS: Six hundred sixty-four cases were analyzed. The median age of patients was 2.6 years; 11.4% were undernourished. The 3 most common mechanisms of injury were suspected child abuse (40.5%), fall (36.6%), and struck-not child abuse (9.7%). Hepatic injury (46.1%) was the most common intra-abdominal injury, followed by splenic (26%), hollow viscous (17.9%), and pancreatic (8.6%) injuries. Eighty-four percent of deaths were related to suspected child abuse. There was a greater proportion of children with suspected child abuse in every patient and injury characteristics studied than all other mechanisms combined. In a regression model including age, undernourishment, pancreatic injury, hollow viscous injury, traumatic brain injury, and mortality, all variables were significantly associated with suspected abuse. Hollow viscous injury had the highest odds ratio (OR, 9.5; confidence limits, 5.7, 15.8), whereas traumatic brain injury had the lowest (OR, 3.6; confidence limits, 2.4, 5.6). CONCLUSIONS: Young children with severe pancreatic or hollow viscous injuries or severe abdominal injuries in the context of either brain injury or undernourishment should be evaluated for the possibility that these injuries resulted from abuse. Increasing the awareness of the possibility of child abuse associated with a set of injury characteristics may allow for more consistent and complete medical evaluation.

Blunt abdominal injury in the young pediatric patient: child abuse and patient outcomes.

This study sought to evaluate injury causes and patient outcomes in young children with abdominal injuries. Cases of blunt abdominal injury (N = 927) to children ages 0 to 4 years were extracted from the National Pediatric Trauma Registry. Measures included hospital utilization (days hospitalized, intensive care unit use, and surgery) and patient outcome (in-hospital fatality, discharge to rehabilitation facility, home rehabilitation, and home nursing). The three most common mechanisms of abdominal injury were motor vehicles (61.27%), child abuse (15.75%), and falls (13.59%). Hospital utilization was higher in patients with multisystem injuries. Patient outcomes were more severe in abused children or those with concomitant central nervous system (CNS) injury; these were the only variables independently associated with increased mortality in this sample. Pediatric abdominal trauma leads to intense use of hospital resources and a high risk of in-hospital mortality. Child abuse, compared to falls, is independently associated with a 6-fold increase in in-hospital mortality.

Health behaviors in cancer survivors.

PURPOSE/OBJECTIVES: To describe health behaviors of cancer survivors by cancer diagnosis and to compare them to people without a personal or family cancer history. DESIGN: Cross-sectional secondary data analysis. SETTING: A national, list-assisted telephone survey using random-digit dialing of U.S. adults about use of cancer-related information and cancer beliefs. SAMPLE: 619 cancer survivors and 2,141 participants without a history of cancer from the original 6,369 Health Information National Trends Survey (HINTS) respondents. METHODS: Using the National Cancer Institute's 2003 HINTS, further analyses were conducted. MAIN RESEARCH VARIABLES: Cancer history, current smoking, fruit and vegetable consumption, physical activity, and body mass index (BMI). FINDINGS: When controlling for demographic variables, no differences were found in self-reported health behaviors between survivors and those without cancer: 22.5% of survivors and 18.4% of those without cancer were current smokers, 18% of survivors and 14.9% of those without cancer consumed at least five fruits or vegetables per day, 45.3% of survivors and 53% of those without cancer were physically active at least weekly, and 58% of survivors and 54.9% of those without cancer were overweight or obese (i.e., BMI > 25). Only 7.4% of survivors and 6.4% of participants without cancer reported positively on all three health behaviors and had a healthy or normal weight. CONCLUSIONS: Survivors did not have different health behaviors when compared to participants without a history of cancer. Neither group met the American Cancer Society or Healthy People 2010 objectives for these behaviors. Adoption of healthy lifestyle behaviors should be addressed in cancer survivors. IMPLICATIONS FOR NURSING: Cancer survivors need to be assessed for current smoking, dietary habits, physical activity, and weight. Information and resources should be made available, if needed, to promote the adoption of healthy lifestyle behaviors.

Screening practices in cancer survivors.

INTRODUCTION: Ten percent of all new cancers are diagnosed in cancer survivors and second cancers are the sixth leading cause of cancer deaths. Little is known, however, about survivors' screening practices for other cancers. The purpose of this study was to examine the impact of a cancer diagnosis on survivors' screening beliefs and practices compared to those without a cancer history. MATERIALS AND METHODS: This study examined cancer survivors' (n = 619) screening beliefs and practices compared to those without cancer (n = 2,141) using the National Cancer Institute's 2003 Health Information National Trends Survey (HINTS). RESULTS: The typical participant was Caucasian, employed, married, and female with at least a high school education, having a regular health care provider and health insurance. Being a cancer survivor was significantly associated with screening for colorectal cancer but not for breast or prostate cancer screening. Screening adherence exceeded American Cancer Society recommendations, national prevalence data, and Healthy People 2010 goals for individual tests for both groups. Physician recommendations were associated with a higher level of screening but recommendations varied (highest for breast cancer and lowest for colorectal cancer screening). CONCLUSIONS: Cancer survivors had different health beliefs and risk perceptions for screening compared to the NoCancer group. While there were no differences between survivors' screening for breast and prostate cancer, survivors were more likely to screen for colorectal cancer than the comparison group. Screening adherence met or exceeded recommendations for individual tests for both cancer survivors and the comparison group. IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors should continue to work with their health care providers to receive age and gender appropriate screening for many types of cancers. Screening for other cancers should also be included in cancer survivorship care plans.