2.50
Hdl Handle:
http://hdl.handle.net/10755/165662
Category:
Abstract
Type:
Presentation
Title:
Diagnostic Delay in Women With A Breast Problem
Author(s):
Crane-Okada, R.
Author Details:
R. Crane-Okada
Abstract:
Significance. The awareness of having a breast problem is often accompanied by distress about a possible diagnosis of breast cancer. Nurses are often the first health care professional with whom women have contact when seeking care. Problem. Delays in definitive diagnosis of a breast problem may compound the distress experience for women and result in negative effects on health and well-being. Purpose. (1) To describe diagnostic delay and contributing factors, in women with an undiagnosed breast problem. (2) To explore a patient diagnostic delay model. Theoretical/Scientific Framework. Freeman’s (1989) model of poverty, culture, and cancer; Thomas’ (1978) critical periods in adjustment to breast cancer; Hammen’s (1992) Cognitive-Life Stress-Interpersonal Model of Depression. Methods. Design--Descriptive, correlational, cross-sectional. Sample—Non-probability, convenience sample, women 18 or older, able to read and write in English, referred for evaluation of an undiagnosed breast problem, and with no personal history of breast cancer. Setting--Surgical breast clinic of an urban public hospital in Southern California. Data collection took place over one year. Main Study Variables--Breast symptoms, social support, beliefs about breast cancer, uncertainty, coping, anxiety, depression, and diagnostic delay [patient (PD), referral (RD), appointment (AD), medical outcome (OD)]. Instruments retained for this analysis had good internal consistency (>.70). Procedures--With informed consent, study participants completed a questionnaire while waiting to see a surgeon. Data Analysis/Evaluation. Descriptive statistics, linear regression, survival analysis (Cox proportional hazards model). Findings & Implications. Subjects were non-white (60%), 40.2 y.o. (19-64), educated beyond high school (58.8%), single (48.7%), uninsured (80.8%), low income (57% <$15K/year), and referred by a health care provider (93.3%) for a palpable mass (65%). There were no significant differences by age, ethnicity, or income for any measure of delay. PD--The average time from self-discovery of a problem (N=87) to seeking care was 2.1 months. Stepwise regression analyses revealed that the only factor significantly associated with decreased PD was having more relatives nearby. RD--Subjects (N=109) waited .83 weeks (0-14.3) after initial evaluation to get a breast clinic referral. AD--Subjects (N=109) waited 7 weeks (0-44.9) for the breast clinic appointment. OD—Some subjects had a diagnosis at the first breast clinic visit (27.5%); the majority (72.5%) required further diagnostic evaluation. Some never completed that evaluation (N=25). Those who did (N=62) had a definitive diagnosis by 6.3 weeks (range .3-17). Breast cancer was diagnosed in three subjects. Model for PD: A Cox proportional hazards model showed only that knowing someone with breast cancer and having fewer breast symptoms were significantly related to less PD. Results suggest that having more relatives in geographic proximity may help women seek care promptly for a breast problem. Other factors may account for delay that were not measured. The small sample allowed only fairly simple models to be tested. Further study is needed.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDiagnostic Delay in Women With A Breast Problemen_GB
dc.contributor.authorCrane-Okada, R.en_US
dc.author.detailsR. Crane-Okadaen_US
dc.identifier.urihttp://hdl.handle.net/10755/165662-
dc.description.abstractSignificance. The awareness of having a breast problem is often accompanied by distress about a possible diagnosis of breast cancer. Nurses are often the first health care professional with whom women have contact when seeking care. Problem. Delays in definitive diagnosis of a breast problem may compound the distress experience for women and result in negative effects on health and well-being. Purpose. (1) To describe diagnostic delay and contributing factors, in women with an undiagnosed breast problem. (2) To explore a patient diagnostic delay model. Theoretical/Scientific Framework. Freeman&rsquo;s (1989) model of poverty, culture, and cancer; Thomas&rsquo; (1978) critical periods in adjustment to breast cancer; Hammen&rsquo;s (1992) Cognitive-Life Stress-Interpersonal Model of Depression. Methods. Design--Descriptive, correlational, cross-sectional. Sample&mdash;Non-probability, convenience sample, women 18 or older, able to read and write in English, referred for evaluation of an undiagnosed breast problem, and with no personal history of breast cancer. Setting--Surgical breast clinic of an urban public hospital in Southern California. Data collection took place over one year. Main Study Variables--Breast symptoms, social support, beliefs about breast cancer, uncertainty, coping, anxiety, depression, and diagnostic delay [patient (PD), referral (RD), appointment (AD), medical outcome (OD)]. Instruments retained for this analysis had good internal consistency (&gt;.70). Procedures--With informed consent, study participants completed a questionnaire while waiting to see a surgeon. Data Analysis/Evaluation. Descriptive statistics, linear regression, survival analysis (Cox proportional hazards model). Findings &amp; Implications. Subjects were non-white (60%), 40.2 y.o. (19-64), educated beyond high school (58.8%), single (48.7%), uninsured (80.8%), low income (57% &lt;$15K/year), and referred by a health care provider (93.3%) for a palpable mass (65%). There were no significant differences by age, ethnicity, or income for any measure of delay. PD--The average time from self-discovery of a problem (N=87) to seeking care was 2.1 months. Stepwise regression analyses revealed that the only factor significantly associated with decreased PD was having more relatives nearby. RD--Subjects (N=109) waited .83 weeks (0-14.3) after initial evaluation to get a breast clinic referral. AD--Subjects (N=109) waited 7 weeks (0-44.9) for the breast clinic appointment. OD&mdash;Some subjects had a diagnosis at the first breast clinic visit (27.5%); the majority (72.5%) required further diagnostic evaluation. Some never completed that evaluation (N=25). Those who did (N=62) had a definitive diagnosis by 6.3 weeks (range .3-17). Breast cancer was diagnosed in three subjects. Model for PD: A Cox proportional hazards model showed only that knowing someone with breast cancer and having fewer breast symptoms were significantly related to less PD. Results suggest that having more relatives in geographic proximity may help women seek care promptly for a breast problem. Other factors may account for delay that were not measured. The small sample allowed only fairly simple models to be tested. Further study is needed.en_GB
dc.date.available2011-10-27T12:22:41Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:41Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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