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Author: Renee Stephanie Walker Publisher: ISBN: 9780549561057 Category : Languages : en Pages : 104
Book Description
Background. Regular mammography screening has been shown to be the most effective means of detecting breast cancer and reducing mortality. Yet, screening rates for African-American women have consistently been lower than their white counterparts. The purpose of this study is to determine physician patterns for mammogram referral after using a reminder system, to assess the number of women who received a mammogram after receiving a referral, and to identify the barriers to mammography after receiving a referral among predominately African-American women seen in an urban primary care setting.
Author: Renee Stephanie Walker Publisher: ISBN: 9780549561057 Category : Languages : en Pages : 104
Book Description
Background. Regular mammography screening has been shown to be the most effective means of detecting breast cancer and reducing mortality. Yet, screening rates for African-American women have consistently been lower than their white counterparts. The purpose of this study is to determine physician patterns for mammogram referral after using a reminder system, to assess the number of women who received a mammogram after receiving a referral, and to identify the barriers to mammography after receiving a referral among predominately African-American women seen in an urban primary care setting.
Author: Christine Krekel Publisher: ISBN: Category : Languages : en Pages : 52
Book Description
PURPOSE: To compare physician referral practices and attitudes for hereditary breast cancer between clinical practice locations: urban, suburban, and rural. METHODS: 214 physicians in Southwest Ohio's Tristate Region completed a self-administered questionnaire to assess referral practices and attitudes for hereditary breast cancer. Respondents were randomly sampled and grouped retrospectively into clinical practice location groups based on self-reported descriptor of practice location: suburban (39%), rural (32%), and urban (17%). Physician medical specialties included family practice, general practice, general surgery, internal medicine, obstetrics/gynecology, and oncology. RESULTS: Rural-practice physicians were less likely to have ever referred for hereditary breast cancer than suburban-practice physicians. Rural practice physicians were more likely to refer to an oncologist for this indication, whereas urban-practice physicians were more likely to refer to a genetic counselor. Rural practice physicians reported stronger barriers to referral, including distance to services and lack of awareness of services. Of all physicians who reported never referring, 61% reported having no need for such services, irrespective of clinical practice location. CONCLUSIONS: Women residing in rural areas are less likely to be referred for genetic services regarding hereditary breast cancer than their suburban counterparts. The reduced referral frequency among rural-practice physicians is partly due to increased barriers to referral. A significant proportion of physicians, regardless of practice location, may not recognize the benefit of genetic counseling and testing for hereditary breast cancer. Further studies are needed to investigate factors that influence physician referral for this indication, and that may vary by clinical practice location, including specialty, physician knowledge, and patient interest, and to assess the perceived value of genetic services among all physicians.
Author: Sophia Siedlikowski Publisher: ISBN: Category : Languages : en Pages :
Book Description
"Context: Growing evidence nuancing the benefits and harms of mammography screening has put systematic screening into question. Given the responsibility of primary care providers in counseling women in mammography decision-making, it is important to understand their thoughts on this process. Understanding primary care providers' perspectives on clinical research on mammography will also help inform future best practices as guidelines evolve. Objective: 1) To explore the perspectives and approaches of primary care providers with respect to mammography decision-making with average-risk women, and 2) To explore physician perspectives on evidence-based research synopses on mammography for average-risk women and how they may apply this information in practice. Design: Critical interpretive review and dynamic cohort study. Methods: First, a critical interpretive review was conducted, using an interpretive descriptive analytical framework that drew on primary care providers' codes of ethics. Ovid MEDLINE®, Scopus, and PsycInfo databases were searched from 2002 to 2018. Following an inductive analysis of the data extracted from the included articles, resulting themes were subjected to an interpretative descriptive analysis. Second, the Essential Evidence Plus database was searched to identify POEMs (Patient Oriented Evidence that MattersTM), clinical research summaries on mammography evidence. Using the Information Assessment Method (IAM), physician ratings and comments about mammography evidence were extracted from reflections on the POEMs. Quantitative data were assessed with descriptive statistics; qualitative data were summarized and assessed iteratively and thematically. Connections were sought between both sources of data. Results: This thesis revealed that physicians hold a wide range of perspectives and practice patterns and perspectives regarding mammography screening for average-risk women. Primary care providers greatly differed in terms of their beliefs in screening effectiveness, their level of trust in screening guidelines, and their thoughts about the recommended age at which average-risk women should begin mammography screening. The critical interpretive review included nine articles that highlighted numerous factors influencing a primary care provider's decision to order mammography screening in addition to professional guidelines. These factors include: providers' beliefs on screening effectiveness, patients' anxiety and requests to be screened, physicians' colleagues' practice patterns, clinical time, and providers' feelings of potential regret about missing diagnoses. The POEMs analysis yielded four POEMs on mammography screening and the number of quantitative POEM ratings ranged from 1243 to 1351. Across all four POEMs, among the physician ratings about using the information for a patient, over 50% were about using it in a discussion with a patient or other healthcare provider. This study showed divergences in the ways in which physicians value and use clinical evidence on mammography screening. Overall, physicians' opinions on the quality of the research used to inform the POEM information and the worth of mammography screening greatly differed. Physicians were divided on the usefulness of POEMs in screening discussions with patients, due to patient, provider, and system-related factors. Physicians also pointed out that a strong screening culture affects both providers' and women's screening decision-making. Conclusions: Primary care providers hold a diversity of perspectives and approaches with respect to mammography screening for average-risk women. The complexity of current evidence on the harms and benefits of screening, coupled with the uniqueness of each patient's values and preferences, warrant increasingly patient-centered approaches to mammography decision-making. Further research should continue to examine ways of optimizing screening decision-making for primary care providers and their patients." --
Author: Lacrisha Go Publisher: ISBN: Category : Languages : en Pages :
Book Description
Abstract Background: Mammogram screening for surveillance and detection of breast cancer has long been recognized as a preventative health measure for women. However, easily recognizing when to screen individual women, based on age and risk factors, lacks clear guidance and often ends in fragmented and inconsistent practices among providers. Methods: By developing and implementing the Screening Mammogram Initiation Protocol (SMIP), the desired goals of this project were to: a) align breast cancer screening recommendations to better meet individualized patient needs in primary care utilizing best practice guidelines, b) increase the rate of breast cancer screening across various demographics, and c) create a standardized screening protocol tool that increases shared decision making based on individual risk factors. Outcome measures were reflected by an increase in provider knowledge towards female breast health counseling, an increase in rates of breast cancer screening discussions, and the successful implementation of the SMIP at a local primary care clinic. Results: Responses from the pre/post knowledge and post-implementation surveys showed improved provider understanding of the current breast cancer screening guidelines for average and high-risk females as well as 90% satisfaction utilizing the SMIP in practice. Electronic data collection after nine-weeks showed an eight percent increase in referrals for women aged 40-49 eligible for breast cancer screening and seven percent increase in referrals for women aged 50-59 respectively. Conclusion: This evidence-based change in practice project improved the quality of care by enhancing preventative health delivery, contributed to increased screening, and likely impacted breast cancer morbidity, and mortality rates.
Author: Christine Natan Publisher: ISBN: Category : Languages : en Pages :
Book Description
Breast cancer is a major public health concern in the United States and remains a priority for national women’s health centers, primary care practices and cancer control organizations such as the American Cancer Society (ACS). The cancer care continuum includes the spectrum of prevention/risk reduction, early detection, treatment, and living with the diagnosis. Currently there are no proven primary prevention options for women at average risk of developing breast cancer; therefore, secondary prevention interventions such as screening mammography and clinical breast examination (CBE) are required to reduce morbidity and mortality. This manuscript describes a Doctor of Nursing Practice (DNP) led quality improvement project aimed at increasing mammography screening completion rates in one community health center within a reputable safety-net community health network with access to a mobile mammography van. The intent of this project was to discover the barriers that patients view in complying with their breast cancer screening recommendation, the workflow of the health centers with the best practice, and the creation of a mammography toolkit to provide consistency in processes amongst multiple sites. Although there were challenges in reaching a significant amount of patients to unveil all the possible barriers, overall implementation of this quality improvement project resulted in a well appreciated mammography toolkit, which will be available to all primary care health centers and included in the orientation of medical evaluation workers and health workers as it relates to patients obtaining proper breast health. Keywords: screening mammography, telephone reminder calls, toolkit, DNP
Author: Renee Stephanie Walker
Author: Renee Stephanie Walker
Author: Christine Krekel
Author: Sophia Siedlikowski
Author: Rose Mary Ross
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Author: 
Author: Rita A. Dekker
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Author: Lacrisha Go
Author: Christine Natan