Showing papers by "Carolyn C. Gotay published in 2002"

Determinants of the degree of complementary and alternative medicine use among patients with cancer

Abstract: Objectives: This study explored the use of complementary and alternative medicine (CAM) by degree of use (nonuse, light, moderate, and heavy) by patients with cancer as it relates to sociodemograph...

Ethnic differences in quality of life among early breast and prostate cancer survivors.

Abstract: This study assessed quality of life (QOL) in recently diagnosed breast and prostate cancer patients of European American and Asian Pacific Islanders (specifically, individuals of Filipino, Japanese, and Native Hawaiian ancestry) to investigate whether QOL varied according to ethnicity and the relative importance of ethnicity as a predictor of QOL. Participants were identified through consecutive registrations on the Hawaii Tumor Registry, based on a diagnosis of breast or prostate cancer 4-6 months previously. QOL was measured by the QLQ-C30, a standardized questionnaire widely used in cancer patient populations. Two hundred and twenty-seven individuals participated (101 prostate and 126 breast cancer patients). QOL was similar across ethnic groups in most areas of QOL. However, differences were found in several areas, all in the direction of Filipino patients reporting worse outcomes. Hierarchical stepwise regressions supported the importance of ethnicity, controlling for clinical and demographic predictors. We conclude that additional research is needed to understand the relationship between ethnicity and QOL in cancer survivors.

Supports and Obstacles to Cancer Survival for Hawaii's Native People

Abstract: purpose: Investigators have suggested that high cancer mortality rates among Native Hawaiians are due to fatalistic attitudes toward the disease, poor access to care, and lack of consideration of Native Hawaiian cultural values in Western approaches to healthcare. This study used qualitative methods to examine these factors in Native Hawaiian cancer survivors. methods: Eight focus groups were held on five islands, attracting 45 Native Hawaiian cancer survivors from both rural and urban locales. The focus groups explored survivors' experiences with cancer diagnosis, treatment, and recovery. Participatory research methods were used, with researchers gaining community input on study design, incorporating appropriate Native Hawaiian cultural protocols into the focus groups, and engaging participants in the interpretation of the data. results: Similar to cancer survivors of other ethnicities, these individuals demonstrated the following: success in accessing healthcare information, professionals, facilities, and insurance; the ability to overcome the barriers confronted; and proactive health behaviors regarding screening, diagnosis, and treatment. They also demonstrated ways in which they were sustained through the cancer experience by Native Hawaiian traditions, such as helping others, gaining strength from Hawaiian spiritual beliefs, and relying on family for personal support. Participants did not respond passively to their cancer diagnoses, and they expressed few fatalistic attitudes. Participants did give numerous examples of other Native Hawaiians who did not seek screening or treatment for cancer because they lacked insurance, had poor access to care, or felt alienated by Western healthcare. clinical implications: The findings suggest that improving access to care and incorporating cultural values in health education and services can enhance survivorship and quality of life for Native Hawaiians with cancer. These themes may have applications for other minority groups.

Assessment of quality of life in a multicultural cancer patient population.

Abstract: Quality of life (QOL) is increasingly assessed in cancer patients. In this article, the authors examined the psychometric performance of a commonly used QOL questionnaire, the Quality of Life Questionnaire--Cancer 30 (QLQ-C30; N. K. Aaronson et al., 1993), in multiethnic cancer patients. Content validation studies in patients and clinicians identified possible new items. Multiple-group confirmatory factor analysis supported equivalent structure across ethnic groups (Caucasians and Asian/Pacific Islanders [APIs]). A higher order QOL factor appeared to directly affect functioning scales and symptom count. Exploratory factor analysis examined effects of new items. Ten factors were extracted, 6 consistent with the original instrument and 4 reflecting potentially new aspects of QOL: Positive Social Support, Coping, Existential Well-Being, and Sexuality/Intimacy. The QLQ-C30 appears appropriate for use in API cancer patients. Further work needs to ensure that it includes all important domains.

Preferences for Psychosocial Interventions Among Newly Diagnosed Cancer Patients from a Multiethnic Population

Abstract: This article addresses preferences for psychosocial interventions in newly diagnosed cancer patients in a multiethnic sample consisting of Americans of European, Filipino, Native Hawaiian, and Japanese ancestry. Patients who were diagnosed with cancer four to six months before the study were identified through consecutive registrations on the Hawai'i Tumor Registry. Data were collected through personal interviews using a standardized questionnaire. Among 194 patients who participated in the study, 162 (84%) reported experiencing cancer-related stress. Although few patients had participated in supportive interventions, there was considerable interest in these techniques. Most patients had received information about diagnosis and treatment, but only 10% had received information about psychological counseling. When preferences for supportive interventions were linked with demographic characteristics (e.g., gender, age, and ethnicity), the most consistent finding was higher levels of interest among Filipino patients. Additional research examining ethnic differences in preferences for psychosocial support is warranted. Because of the potential for greater use of behavioral therapies by patients, educating providers about the availability, efficacy, and patients' interest in such interventions is needed.

Oncologists’ Knowledge, Attitudes and Practices Related to Cancer Treatment Clinical Trials

Abstract: Native Hawaiians have high incidence rates of cancers diagnosed in late stages and, thus, many might benefit from participation in cancer clinical trials. A survey was developed to explore knowledge, attitudes, and practices of Hawai’i oncologists with regard to cancer treatment clinical trials and Native Hawaiian participation in them. Findings suggest that most cancer specialists are supportive of clinical trials. However, physicians identified a number of barriers to Native Hawaiian participation in clinical trials. Ways to increase participation in clinical trials are suggested.

Pain assessment in Hawaii nursing homes.

Abstract: Nursing home personnel from adult long-term care facilities on Oahu were surveyed on their pain assessment practices with demented and non- verbal residents. Many reported ha ving difficulties evaluating pain in these residents. Observation and standardized pain assessment scales were most frequently used pain assessment methods. Recommendations are made about how to improve pain assessment with demented and non-verbal patients.