INFORMATION NEEDS OF AFRICAN AMERICAN CANCER PATIENTS

点击翻译按钮获取中文摘要

A study is proposed to explore information seeking, patient- provider communication, participation in treatment decision making, and emotional adjustment of a random sample of 250 African American and 250 White cancer patients and their families. Subjects will be identified from hospital tumor registries. The study partially replicates and expands a previous study exploring information seeking and treatment participation of White cancer patients (Manfredi, Czaja, Price, Ruis, and Jansizewski, 1993a). The proposed study expands previous work by exploring racial, economic, and psychosocial predictors of information seeking. African American and White samples will be matched on patient characteristics: age, gender, cancer site (breast, colon, prostate), time since diagnosis, and size of hospital where the patient was first diagnosed or treated. Data will be collected through telephone interviews of the patients to determine: 1) the information needs and information-seeking activities of the patients and their families at the time of diagnosis and sine then; 2) patient-provider communication about care decisions; 3) participation in treatment decision making; 4) the extent to which the three items above are influenced by sociopsychological characteristics of the patient, including SES (education and type of employment), type of insurance coverage, disease related factors, and coping style and resources; 5) whether the patient sought and received a second opinion or consultation or was offered or participated in a clinical trial; and 6) the patient's adjustment to the disease. The specific goals of the study are to: 1. To revise, expand and pretest the questionnaire used in the previous study of information seeking with White cancer patients (Manfredi, et al., 1993). Expansion will include adding validated psychometric instruments assessing psychosocial factors thought to affect patient information seeking and new items to assess the potential impact of race on variables such a patient-provider communication. 2. To identify and interview a random sample of 250 African American and 250 White cancer patients, stratified by cancer site (breast, prostate, colon-rectum), and matched on months since diagnosis (3-6, 7-10, 11-14), age group (less than or equal to 50, 51-64, greater than or equal to 65), gender, and size of hospital at diagnosis. 3. To analyze the above data. The main focus of the analysis will be to: a) describe the coping styles, patient-provider communication patterns, informational needs, information-seeking activities, participation in treatment decision-making, and emotional adjustment to their disease of African-American cancer patients; b) compare these characteristics with those of White cancer patients; c) explore patterns of interactions among these variables, how they are influenced by demographic and illness characteristics; and how these patterns are affected by race; d) develop a theoretical model that predicts information-seeking, participation in treatment decision making process, and emotional adjustment among individuals facing a diagnosis of cancer, based on predisposing, enabling, and reinforcing socio-psychological factors taking into consideration the effect of demographic and illness variables; and e) assess the potential effect of race and related mediating factors on the above model.