Showing papers by "Zeev Rosberger published in 2013"

Barriers and facilitators of adherence to medical advice on skin self-examination during melanoma follow-up care

Abstract: Melanoma is the fastest growing tumor of the skin, which disproportionately affects younger and middle-aged adults. As melanomas are visible, recognizable, and highly curable while in early stages, early diagnosis is one of the most effective measures to decrease melanoma-related mortality. Skin self-examination results in earlier detection and removal of the melanoma. Due to the elevated risk of survivors for developing subsequent melanomas, monthly self-exams are strongly recommended as part of follow-up care. Yet, only a minority of high-risk individuals practices systematic and regular self-exams. This can be improved through patient education. However, dermatological education is effective only in about 50% of the cases and little is known about those who do not respond. In the current literature, psychosocial variables like distress, coping with cancer, as well as partner and physician support are widely neglected in relation to the practice of skin self-examination, despite the fact that they have been shown to be essential for other health behaviors and for adherence to medical advice. Moreover, the current body of knowledge is compromised by the inconsistent conceptualization of SSE. The main objective of the current project is to examine psychosocial predictors of skin self-examination using on a rigorous and clinically sound methodology. The longitudinal, mixed-method study examines key psychosocial variables related to the acquisition and to the long-term maintenance of skin self-examination in 200 patients with melanoma. Practice of self-exam behaviors is assessed at 3 and 12 months after receiving an educational intervention designed based on best-practice standards. Examined predictors of skin self-exam behaviors include biological sex, perceived self-exam efficacy, distress, partner and physician support, and coping strategies. Qualitative analyses of semi-structured interviews will complement and enlighten the quantitative findings. The identification of short and long-term predictors of skin self-examination and an increased understanding of barriers will allow health care professionals to better address patient difficulties in adhering to this life-saving health behavior. Furthermore, the findings will enable the development and evaluation of evidence-based, comprehensive intervention strategies. Ultimately, these findings could impact a wide range of outreach programs and secondary prevention initiatives for other populations with increased melanoma risk.

Deconstructing Human Papillomavirus (HPV) Knowledge: Objective and Perceived Knowledge in Males' Intentions to Receive the HPV Vaccine

Abstract: Background: The human papillomavirus (HPV) vaccine was recently approved for men. To effectively tailor HPV education efforts toward men, it is important to understand what men know about HPV and how this knowledge relates to their decision to receive the vaccine. This study examines how objective HPV knowledge, objective HPV vaccine knowledge, and perceived knowledge (level of confidence in one's HPV knowledge) relate to males' HPV vaccination intentions. Methods: One hundred and twenty-eight college men completed a questionnaire survey assessing their demographics, sexual health, and objective and perceived knowledge of HPV and the HPV vaccine. Results: Logistic regression analyses revealed that perceived knowledge and objective HPV vaccine knowledge were associated with vaccination intentions. Perceived knowledge was significantly associated with vaccination intentions even when accounting for objective HPV and HPV vaccine knowledge. Discussion and Translation to Health Education Practice: Perceived kn...

The experience of pain and anxiety in rectal cancer patients during high-dose-rate brachytherapy

Abstract: Background Pain and anxiety have been reported as primary concerns for patients with head-and-neck, gynecologic, and prostate cancers undergoing high dose rate (hdr) brachytherapy. However, almost no research has been published on the degree to which these symptoms are experienced by rectal cancer patients undergoing hdr brachytherapy. We conducted a pilot study examining the experiences of rectal cancer patients during hdr brachytherapy, specifically the intensity and trajectory of their anxiety and pain. Methods Rectal cancer patients ( n = 25) who received hdr brachytherapy treatment at a hospital in Montreal, Quebec, completed verbal analog scales for pain and anxiety at 4 time points over 4 treatment days. Results On all 4 days, a subset of patients reported moderate to-severe anxiety before applicator insertion. Pain increased significantly from the time patients were lying on the table to immediately after insertion of the applicator ( p < 0.001). Insertion of the applicator appears to be the most painful part of the procedure, and although anxiety declined to below baseline after applicator removal, pain remained somewhat elevated. Some patients required conscious sedation; however, reports of moderate-to-severe pain were more frequent from patients who received pain medications than from patients who did not receive such medication ( p < 0.05). Conclusions Most patients with rectal cancer tolerated hdr rectal brachytherapy well, although the procedure is stressful and painful for some. Insertion of the applicator was found to be the point of maximal pain, and medication was not always completely successful at alleviating the pain, suggesting that additional psychosocial interventions might be needed, with particular emphasis on the time of applicator insertion.

a significant challenge in the battle against HPV

Abstract: H PV accounts for 5.2% of the worldwide cancer burden, including all cervical cancers, 50% of penile cancers and 88% of anal cancers. Two vaccines have recently been developed and licensed to target specific oncogenic and non-oncogenic types of HPV. In 2006, the Canadian government supported a vaccination program for girls aged 9 to 13 and female vaccination rates in this popula- tion in Canada now range from 50% in Alberta to 86% in Quebec. There are compelling reasons to include boys in the vaccination campaign as well. Two provinces have recently stated their intention to do so. Perceptions of individuals and parents are important in vaccine acceptance. Understanding how their decisions are made will help design measures to improve vaccine uptake.