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The study described perceived breast cancer risk compared subjective and objective risk estimates and examined the influence of heuristic reasoning in women's narratives. The survey used three probability scales (Verbal Comparative Numerical) and the Gail model to measure perceived and objective risk. Aim 3 was addressed with argument and heuristic reasoning analysis. We recruited a multicultural educated sample of 184 English-speaking women from community settings. Fifty four provided an in-depth interview. Participants held an optimistic bias regarding their breast cancer risk (comparative optimism and better-than-average) and underestimated their objective risk calculated with the Gail model. Breast cancer worry was a significant predictor of breast cancer risk. Better-educated and higher-income women reported lower levels of worry while Black women were more likely than Asian and White women to report higher levels of worry but not higher levels of perceived risk. Most participants did not know that older age is a breast cancer risk factor and older women did not perceive higher risk. These findings imply that women's knowledge of breast cancer risk factors was incomplete despite their high educational level. Age and family history are independent predictors of sporadic and hereditary/familial breast cancer risk; yet women could not distinguish between the two forms of the disease. Most participants (70%) were adherent to mammography and clinical breast exam (CBE) screening guidelines which can be attributed to high access to screening services and efforts from health care providers. Age having health insurance and higher 5-year Gail scores were significant predictors of frequency of screening mammograms and CBEs. Distrust of the health system was the single most important predictor of predisposition to use health services which in turn was another significant predictor of screening mammograms and CBEs.
Breast cancer screening is currently the most reasonable strategy for reducing the impact of breast cancer on women. However, increased perceived risk and psychological distress have been associated with lower screening rates. The specific aims for this study were to: (1) assess the psychological distress of women ages 50 to 85 who receive breast cancer risk appraisal and randomization to immediate or delayed group psychosocial counseling; (2) assess their breast cancer screening behaviors over 2 years from the time of enrollment; (3) evaluate the degree of association between perceived and estimated risk of breast cancer; (4) describe short-term psychological reactions to breast cancer risk appraisal; and (5) describe their sense of coherence, coping style, other health-related behaviors, social support, and perceived quality of life. This study was conducted to provide important information about women's reactions to breast cancer risk appraisal and ways to enhance positive health behaviors. A total of 343 women participated in the study (mean age, 62 years). Each participant completed a breast cancer risk assessment form and received an estimate of their risk. Participants were randomized to either an immediate or delayed psychosocial counseling intervention on breast health. Results of the intervention showed largely non-significant changes in psychological distress and breast cancer screening behaviors (p>O.05). Further analyses will be conducted to provide more detail about these unexpected findings.
Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
This book provides a state-of-the-art, comprehensive review of the many factors that affect women’s health, ranging from low socioeconomic status and the impact of the debt crisis to more direct medical determinants, such as poor nutrition, hemorrhage, eclampsia, and infection. At stake are the unnecessary and preventable deaths of women and girls around the globe. The contributors assess the reduced quality of life for women and the often unacknowledged contributions of women and girls as the backbone of production in both developing and developed countries. Synthesizing perspectives of policymakers and practitioners, researchers and scholars, The Health of Women urges major new initiatives to understand and improve women’s health, taking into account biological elements such as the life cycle of women as well as cultural constraints and socioeconomic realities.
Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.
Annotation This book/manual package provides a clinical framework for health professionals who wish to offer group psychosocial support to breast cancer patients. The package trains therapists to help group members cope with the diagnosis of breast cancer and its treatment and provides empirical validation for the program's techniques. Session- by-session guidelines are supplied in the therapist's manual for each module of the program. A separate companion workbook for group participants is also available. Antoni is professor of psychology, psychiatry, and behavioral sciences at the University of Miami. Annotation c. Book News, Inc., Portland, OR (booknews.com).
This atlas illustrates the latest available data on the cancer epidemic, showing causes, stages of development, and prevalence rates of different types of cancers by gender, income group, and region. It also examines the cost of the disease, both in terms of health care and commercial interests, and the steps being taken to curb the epidemic, from research and screening to cancer management programs and health education.
Provides a comprehensive assessment of the scientific evidence on prevalence and the resulting health effects of a range of exposures that are know to be hazardous to human health, including childhood and maternal undernutrition, nutritional and physiological risk factors for adult health, addictive substances, sexual and reproductive health risks, and risks in the physical environments of households and communities, as well as among workers. This book is the culmination of over four years of scientific equiry and data collection, know as the comparative risk assessment (CRA) project.