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Barbara D Powe - One of the best experts on this subject based on the ideXlab platform.

  • perceptions of cancer Fatalism and cancer knowledge a comparison of older and younger african american women
    Journal of Psychosocial Oncology, 2006
    Co-Authors: Barbara D Powe, Jill B Hamilton, Patrice Brooks
    Abstract:

    Cancer Fatalism (the belief that death is inevitable when cancer is present) may influence cancer screening practices among older African American women. Little is known about cancer Fatalism among younger women. Guided by the Patient/Provider/System Model, this descriptive study compares cancer Fatalism and cancer knowledge among African American college students (n = 353) and women from primary care centers (n = 361). Their average age was 29 years. Data were collected using the Powe Fatalism Inventory and breast and cervical cancer knowledge scales. Women at health centers had higher cancer Fatalism and lower cancer knowledge. Differences in life experiences may help explain these findings.

  • comparing perceptions of cancer Fatalism among african american patients and their providers
    Journal of The American Academy of Nurse Practitioners, 2005
    Co-Authors: Barbara D Powe, Elvan Daniels, Ramona K C Finnie
    Abstract:

    Purpose To describe perceptions of cancer Fatalism and identify demographic correlates; to explore whether providers believe their patients are fatalistic about cancer and compare these views to the patients’ views. Data sources Both patients (n= 52) and providers (n= 35) were recruited at federally funded, community primary care centers. Data were collected using the Powe Fatalism Inventory, the Perceived Patient Fatalism Inventory, and a demographic data questionnaire. Data were analyzed using descriptive statistics, Pearson correlations, and t-test. Conclusions The majority of patients were African American women. The majority of providers were physicians and nurses. Patients indicated low perceptions of cancer Fatalism, but providers believed patients were highly fatalistic. As the patients’ educational level increased, perceptions of cancer Fatalism decreased. Implications for practice The providers’ belief that patients are fatalistic about cancer may influence patient–provider communication. They may be less likely to recommend screening, and patients may be less likely to initiate a discussion about cancer. Strategies are needed that target providers and their patients to address actual and/or perceived perceptions and their influence on cancer screening.

  • cancer Fatalism the state of the science
    Cancer Nursing, 2003
    Co-Authors: Barbara D Powe, Ramona Finnie
    Abstract:

    Cancer Fatalism--the belief that death is inevitable when cancer is present--has been identified as a barrier to participation in cancer screening, detection, and treatment. Yet this literature has not been reviewed in a comprehensive and systematic manner. Therefore, this literature review addressed (1) philosophical and theoretical underpinnings of cancer Fatalism; (2) relationships among demographic factors, cancer Fatalism, and cancer screening; (3) the role of cancer Fatalism for patients diagnosed with cancer; and (4) intervention strategies. Most of the reviewed studies were descriptive or correlational, did not have an explicit theoretical framework, had varied definitions of Fatalism, and reported screening as "intent to screen" or as "past screening behaviors." Review of the studies suggests that cancer Fatalism develops over time and is most frequently reported among medically underserved persons and those with limited knowledge of cancer. Cancer Fatalism may be modified through culturally relevant interventions that incorporate spirituality. Emphasis must be placed on recognizing the role of cancer Fatalism when planning health promotion activities. Future studies should focus on the consistent measurement of cancer Fatalism and testing intervention strategies.

  • an intervention to decrease cancer Fatalism among rural elders
    Oncology Nursing Forum, 1999
    Co-Authors: Barbara D Powe, Sally P Weinrich
    Abstract:

    Purpose/objectives To evaluate the effectiveness of a video intervention in decreasing cancer Fatalism, increasing knowledge of colorectal cancer, and increasing participation in fecal-occult blood testing (FOBT). Design Repeated measures, pretest/post-test. Setting Senior citizen centers in a rural southern state. Sample Individuals were selected and assigned to the study group based on the center they attended. Centers were selected and assigned randomly to an intervention (n = 42) or control (n = 28) group. The age of the participants ranged from 52-92 years (X = 75). Methods Pretest measures included the Powe Fatalism inventory, the Colorectal Cancer Knowledge Questionnaire, and the Demographic Data Questionnaire. The intervention group viewed the Medical University of South Carolina's video Telling the Story ... To Live is God's Will, and the control group viewed the American Cancer Society (ACS) video Colorectal Cancer: The Cancer No One Talks About. Hemoccult II kits were distributed to both groups at no cost. Post-test data were collected using the Powe Fatalism Inventory and the Colorectal Cancer Knowledge Questionnaire. Main research variables Cancer Fatalism, knowledge of colorectal cancer, and participation in FOBT. Findings People who viewed the intervention video had a greater decrease in cancer Fatalism scores and a greater increase in knowledge of colorectal cancer scores than the control group. Both groups had greater than 60% participation in FOBT. Conclusions Telling the Story ... To Live is God's Will is an effective, self-contained, cost-effective intervention to decrease cancer Fatalism and increase knowledge of colorectal cancer. The video was as effective as the ACS video on colorectal cancer in increasing participation in FOBT among rural elders. But, because Telling the Story ... To Live is God's Will also decreases cancer Fatalism and increases knowledge, the potential exists for the increased screening behaviors to be maintained over time. Implications for nursing practice Showing the video in waiting areas of community health centers to facilitate the discussion of colorectal cancer and cancer screening with the healthcare professional is a possibility. Nursing students may benefit from using the video as a model for the integration of beliefs and attitudes in developing culturally appropriate, community-based interventions. More research is needed to determine if the positive outcomes of the intervention (i.e., decreased cancer Fatalism, increased knowledge, increased participation in colorectal cancer screening) can be maintained over time.

  • cancer Fatalism among african americans a review of the literature
    Nursing Outlook, 1996
    Co-Authors: Barbara D Powe
    Abstract:

    Historically, the health status of African-Americans has been significantly lower when compared with the general population. Too often, attempts to explain and understand this occurrence have focused on factors such as poverty, decreased access, under-education, and decreased knowledge of cancer. Despite the providing of screening at reduced costs or educational interventions, the screening rates for African-Americans remains lower than that of the general population. Cancer Fatalism is believed to be an additional barrier to participation in screening for this population. Previous research findings can raise the consciousness of nursing professionals about the influence of cancer Fatalism. There are no easy solutions, and much additional research is needed.

Leonard E Egede - One of the best experts on this subject based on the ideXlab platform.

  • predictors of diabetes Fatalism among arabs a cross sectional study of lebanese adults with type 2 diabetes
    Journal of Religion & Health, 2018
    Co-Authors: Ola Sukkariehharaty, Leonard E Egede, Joelle Abi Kharma, Maya Bassil
    Abstract:

    Fatalism is a grounded cultural belief that is common among Arabs and is known to hinder self-care in chronic diseases including diabetes (Nabolsi and Carson in Scand J Caring Sci 25(4):716-724, 2011). The purpose of this study is to identify predictors of diabetes Fatalism in this population. Data on 280 Lebanese patients with type 2 diabetes (mean age 58.24 ± 13.48 years; mean HbA1c 7.90 ± 1.90%; 53.76% females) recruited from one hospital in greater Beirut, Lebanon, and from the community using snowballing technique were examined. Multiple linear regression was used to assess the independent association between diabetes Fatalism and demographic and patient characteristics. Age (β = -.14, 95% CI -.27, -.002), BMI (β = .35, 95% CI .15; .54), level of education (β = -3.98, 95% CI -7.64; -.32) and number of diabetes problems (β = -5.03, 95% CI -9.89; -.18) were significantly associated with diabetes Fatalism in the regression model. The combination of demographic and patient characteristics accounted for 14.5% of the variance in diabetes Fatalism scores' change. Patients with type 2 diabetes who exhibited more fatalistic attitudes were younger, of lower education levels, had higher BMI and had fewer diabetes comorbidities. Such findings are crucial for healthcare practitioners to identify fatalistic patients and to tailor culturally appropriate strategies in diabetes management. Further studies are warranted to explore other potential determinants of diabetes Fatalism with larger sample and non-Lebanese Arabic population.

  • pathways for the relationship between diabetes distress depression Fatalism and glycemic control in adults with type 2 diabetes
    Journal of Diabetes and Its Complications, 2017
    Co-Authors: Christopher C Asuzu, Rebekah J Walker, Joni S Williams, Leonard E Egede
    Abstract:

    Abstract Background The aim of this study was to examine the mechanism by which depressive symptoms, diabetes distress, and diabetes Fatalism together influence diabetes outcomes using structured equation modeling. Methods 615 adults with type 2 diabetes were recruited from two primary care clinics in the southeastern United States. Psychosocial factors found to be associated with diabetes outcomes were measured using validated questionnaires. Structured equation modeling (SEM) was used to investigate the relationship between diabetes Fatalism, depressive symptoms, diabetes distress, self-care and glycemic control. Results The final model (chi 2 (903)=24,088.91, p 2 =0.93, RMSEA=0.05 and CFI=0.90) showed that higher diabetes distress was directly significantly related to a decreased self-care (r=−0.69, p p p p Conclusion Diabetes distress serves as a pathway through which depressive symptoms and Fatalism impact both glycemic control and self-care. In addition, pathways between diabetes distress and both self-care behaviors and glycemic control in patients with type 2 diabetes remained separate, suggesting the need to address both psychological and behavioral factors in standard diabetes care, rather than focusing on psychological care primarily through support for self-management and treatment of depression.

  • effect of diabetes Fatalism on medication adherence and self care behaviors in adults with diabetes
    General Hospital Psychiatry, 2012
    Co-Authors: Rebekah J Walker, Brittany L Smalls, Melba A Hernandeztejada, Jennifer A Campbell, Kimberly S Davis, Leonard E Egede
    Abstract:

    Abstract Objective Diabetes Fatalism is defined as "a complex psychological cycle characterized by perceptions of despair, hopelessness, and powerlessness" and associated with poor glycemic control. This study examined the association between diabetes Fatalism and medication adherence and self-care behaviors in adults with diabetes. Methods Data on 378 subjects with type 2 diabetes recruited from two primary care clinics in the Southeastern United States were examined. Previously validated scales were used to measure diabetes Fatalism, medication adherence, diabetes knowledge and diabetes self-care behaviors (diet, physical activity, blood sugar testing and foot care). Multiple linear regression was used to assess the independent effect of diabetes Fatalism on medication adherence and self-care behaviors controlling for relevant covariates. Results Fatalism correlated significantly with medication adherence ( r =0.24, P r =−0.26, P r =−0.20, P r =−0.19, P β =0.029, 95% confidence interval (CI) 0.016, 0.043], diabetes knowledge ( β =−0.042, 95% CI −0.001, −0.084), diet ( β =−0.063, 95% CI −0.039, −0.087), exercise ( β =−0.055, 95% CI −0.028, −0.083) and blood sugar testing ( β =−0.055, 95% CI −0.023, −0.087). There was no significant association between diabetes Fatalism and foot care ( β =−0.018, 95% CI −0.047, 0.011). The association between diabetes Fatalism and medication adherence, diabetes knowledge and diabetes self-care behaviors did not change significantly when depression was added to the models, suggesting that the associations are independent of depression. Conclusion Diabetes Fatalism is associated with poor medication adherence and self-care and may be an important target for education and skills interventions in diabetes care. In addition, the effect of diabetes Fatalism is independent of depression, suggesting that interventions that target depression may not be sufficient to deal with diabetes Fatalism.

  • development and psychometric properties of the 12 item diabetes Fatalism scale
    Journal of General Internal Medicine, 2010
    Co-Authors: Leonard E Egede, Charles Ellis
    Abstract:

    This study describes the development and validation of the Diabetes Fatalism Scale (DFS) in adults with type 2 diabetes. Thirty-five items were derived from focus groups, literature review, and expert opinion. The items were pilot tested on 20 adults with diabetes and then administered to 216 primary care patients with type 2 diabetes to assess the validity and reliability of the scale. Exploratory factor analysis (Principal Component Analysis with Varimax rotation) yielded a 12-item scale with three subscales. Pearson’s correlation was used to test the DFS’s association with diabetes self-care, HbA1c and quality of life. Multiple linear regression was used to assess association between the DFS and HbA1c controlling for demographics, comorbidity and insulin use. Cronbach’s alpha for the 12-item DFS scale was 0.804 indicating internal consistency. The DFS is scored in such a way that higher scores represent greater diabetes Fatalism. The DFS scores were not significantly correlated with age, years of education, or diabetes duration. Whites, men, those with government or no insurance, and those with 3+ comorbid conditions had significantly higher DFS scores. DFS was significantly correlated with self management understanding (r = -0.35, p < 0.001), control problems (r = 0.22, p = 0.002), self-care ability (r = -0.30, p < 0.001), and self-care adherence (r = -0.23, p < 0.001). The DFS was significantly correlated with HbA1c (r = 0.20, p = 0.004) and mental health component of SF-12 (r = -0.24, p = 0.001). In multivariate models, adjusting for demographics, comorbidity and insulin use, the DFS was independently associated with increased HbA1c (beta 0.21, p = 0.005). The DFS is a valid and reliable measure of diabetes Fatalism. Diabetes Fatalism is associated with self-care problems, poor glycemic control, and decreased quality of life.

  • diabetes self management in african americans an exploration of the role of Fatalism
    The Diabetes Educator, 2003
    Co-Authors: Leonard E Egede, Ramita Bonadonna
    Abstract:

    PURPOSEThis study was conducted to explore the concept of Fatalism in relation to diabetes self-management behavior in African Americans with type 2 diabetes.METHODSParticipants (n=39) were recruited from a clinic sample of African Americans with type 2 diabetes. Seven focus groups were conducted; the sessions were recorded, transcribed, and analyzed to identify themes related to Fatalism and diabetes self-management. The ISAS paradigm (individual, symbols, audience, situation), a social psychology theory, provided the theoretical framework for the study.RESULTSFour dimensions of Fatalism were identified: the meaning of diabetes, the illness experience, the individual's coping response, and the individual's religious and spiritual beliefs. For the participants in this study, Fatalism seemed to characterize the nature of the interaction between the individual with diabetes and others, the meanings they attached to such interactions, and the decision to adopt an effective or ineffective diabetes self-manage...

Jane Wardle - One of the best experts on this subject based on the ideXlab platform.

  • cancer fear and Fatalism among ethnic minority women in the united kingdom
    British Journal of Cancer, 2016
    Co-Authors: Charlotte Vrinten, Jane Wardle, Laura A V Marlow
    Abstract:

    Cancer fear and Fatalism are believed to be higher in ethnic minorities and may contribute to lower engagement with cancer prevention and early detection. We explored the levels of cancer fear and Fatalism in six ethnic groups in the United Kingdom and examined the contribution of acculturation and general Fatalism. A cross-sectional survey of 720 White British, Caribbean, African, Indian, Pakistani, and Bangladeshi women (120 of each) was conducted. Three items assessed cancer fear and two cancer Fatalism. Acculturation was assessed using (self-reported) migration status, ability to speak English, and understanding of health leaflets; general Fatalism with a standard measure. Relative to White British women, African and Indian women were more fearful of cancer, Bangladeshi women less fearful, and Pakistani and Caribbean women were similar to White British women. Cancer Fatalism was higher in all the ethnic minority groups compared with White British women. Less acculturated women were less likely to worry (ORs 0.21–0.45, all P<0.05) or feel particularly afraid (ORs 0.11–0.31, all P<0.05) but more likely to feel uncomfortable about cancer (ORs 1.97–3.03, all P<0.05). Lower acculturation (ORs 4.30–17.27, P<0.05) and general Fatalism (OR 2.29, P<0.05) were associated with the belief that cancer is predetermined. In general, cancer fear and Fatalism are more prevalent among ethnic minority than White British women and even more so in less acculturated ethnic minorities. This may affect their participation in cancer prevention and early detection.

  • psychological responses to genetic testing for weight gain a vignette study
    Obesity, 2012
    Co-Authors: Susanne F Meisel, Catherine Walker, Jane Wardle
    Abstract:

    Genetic testing for obesity risk is increasingly available to the public but few studies have examined motivational or affective reactions. Here we report findings from a “vignette” study investigating reactions to “higher-risk” and “average-risk” results for the obesity-related FTO gene in two groups: a panel sample of individuals with weight concerns, for whom testing may have treatment implications (n = 306, mean age = 45 years, mean BMI = 35) and a student sample (n = 395, mean age = 25 years, mean BMI = 23), for whom testing would have implications for obesity prevention. Participants were given FTO gene information that described higher-risk alleles as linked with modest weight gain and slightly higher risk of obesity. They responded to both higher- and average-risk vignettes, with order randomized. Interest in genetic testing was high overall, and higher in panel respondents than students (93% vs. 78% would “probably” or “definitely” have the test; P < 0.001). In students, a higher-risk result generated higher motivation to change (d = 0.15; P < 0.001), but also slightly higher negative affect (d = 0.03, P < 0.001) and Fatalism (d = 0.05, P < 0.001) than an average-risk result. Panel respondents also had higher motivation to change (d = 0.17, P < 0.001) as well as relief about having an explanation for their body weight (d = 0.02, P = 0.013) in the higher-risk condition, but no increase in Fatalism or depression. These results suggest that at the level of anticipated responses to FTO gene feedback, higher-risk results had positive motivational effects with minimal changes in negative affect or Fatalism. Genetic testing has the potential to be a useful clinical or preventive tool when combined with appropriate information.

  • cancer Fatalism deterring early presentation and increasing social inequalities
    Cancer Epidemiology Biomarkers & Prevention, 2011
    Co-Authors: Rebecca J Beeken, Alice E Simon, Christian Von Wagner, Katriina L Whitaker, Jane Wardle
    Abstract:

    Background: Fatalistic beliefs about cancer have been implicated in low uptake of screening and delay in presentation particularly in low socioeconomic status (SES) groups, but no studies have systematically evaluated interrelationships between SES, Fatalism, and early detection behaviors. We explored whether (i) Fatalism is associated with negative attitudes toward early detection, (ii) lower SES groups are more fatalistic, and (iii) SES differences in Fatalism partly explain SES differences in attitudes toward early detection. Methods: In a population-representative sample of adults in Britain using computer-based interviews in the home setting, respondents ( N = 2,018) answered two questions to index Fatalism (expectations of cancer survival and cure) and two items on early detection attitudes (the perceived value of early detection and fear of symptom reporting). SES was indexed with a social grade classification. Results: Fatalism was associated with being less positive about early detection ( β = −0.40, P < 0.001) and more fearful about seeking help for a suspicious symptom ( β = 0.24, P < 0.001). Lower SES groups were more fatalistic ( β = −0.21, P < 0.001). Path analyses suggest that SES differences in Fatalism might explain SES differences in attitudes about early detection. Conclusions: In this population sample, SES differences in Fatalism partly explained SES differences in the perceived value of early detection and fear of symptom presentation. Impact: Fatalistic beliefs about cancer should be targeted to promote early presentation of cancer and this may be particularly important for lower SES groups. Cancer Epidemiol Biomarkers Prev; 20(10); 2127–31. ©2011 AACR . This article is featured in Highlights of This Issue, [p. 1991][1] [1]: /lookup/volpage/20/1991?iss=10

  • Psychologic predictors of cancer information avoidance among older adults: The role of cancer fear and Fatalism
    CANCER EPIDEM BIOMAR, 2008
    Co-Authors: Jane Wardle
    Abstract:

    Little is known about the correlates of cancer information avoidance and whether people with negative feelings and beliefs about cancer are more likely to avoid cancer information, allowing such thoughts and feelings to persist unchallenged. Using the Extended Parallel Processing Model as a theoretical guide, we tested the hypothesis that cancer fear and Fatalism would predict cancer information avoidance but that part of this effect would be mediated via cancer-specific threat and efficacy beliefs. A community sample of older adults, ages 50 to 70 years (n = 1,442), completed a postal questionnaire that included the Powe Fatalism Inventory and the Champion Cancer Fear scale along with other measures of cancer-specific beliefs and demographic variables. Higher levels of cancer fear were positively associated with higher levels of cancer information avoidance, and part of this relationship was mediated via perceived cancer severity. The relationship between cancer Fatalism and cancer information avoidance was partly mediated by severity and response-efficacy beliefs. This research shows that people with negative views about cancer are more likely to avoid cancer information. This means people with higher levels of cancer fear and Fatalism are less likely to learn about positive developments made in the field of cancer control, allowing such negative feelings and views to continue. Research needs to focus on how to get positive messages about improvements in cancer prevention and control through to people who are fearful of and fatalistic about the disease.

Lewis B Morgenstern - One of the best experts on this subject based on the ideXlab platform.

  • the impact of pre stroke depressive symptoms Fatalism and social support on disability after stroke
    Journal of Stroke & Cerebrovascular Diseases, 2017
    Co-Authors: Anjail Z Sharrief, Lesli E Skolarus, Lynda D Lisabeth, Brisa N Sanchez, Nelda M Garcia, Darin B Zahuranec, Jonggyu Baek, Erin Case, Lewis B Morgenstern
    Abstract:

    Background Psychological and social factors have been linked to stroke mortality; however, their impact on stroke disability is unclear. The purpose of this study was to evaluate the impact of pre-stroke Fatalism, depressive symptoms, and social support on 90-day neurologic, functional, and cognitive outcomes. Methods Ischemic strokes (2008-2011) were identified from the Brain Attack Surveillance in Corpus Christi Project. Validated scales were used to assess Fatalism, depressive symptoms, and social support during baseline interviews. The National Institutes of Health Stroke Scale, activities of daily living/instrumental activities of daily living (ADL/IADL) scale, and Modified Mini-Mental State Exam (3MSE) were used to assess 90-day outcomes. The associations between the pre-stroke variables and 90-day outcomes were estimated from regression models adjusting for demographics, risk factors, tissue-type plasminogen activator treatment, and comorbidities. Results Among 364 stroke survivors, higher pre-stroke Fatalism was associated with worse functional (.17 point higher ADL/IADL per interquartile range [IQR] higher Fatalism; 95% confidence interval [CI]: .05, .30) and cognitive (2.81 point lower 3MSE per IQR higher Fatalism; 95% CI: .95, 4.67) outcomes. Higher pre-stroke depressive symptoms were associated with worse functional (.16 point higher ADL/IADL per IQR higher Patient Health Questionnaire-9; 95% CI: .04, .28) and cognitive (2.28 point lower 3MSE per IQR higher Patient Health Questionnaire-9; 95% CI: .46, 4.10) outcomes. Participants in the middle tertile of social support had better cognitive outcomes (3.75 points higher 3MSE; 95% CI: .93, 6.56) compared with the highest tertile. Conclusions The associations between pre-stroke Fatalism, depressive symptoms, and social support and 90-day outcomes suggest that psychosocial factors play an important role in stroke recovery.

  • abstract t p146 the impact of pre stroke depressive symptoms Fatalism and social support on disability after stroke
    Stroke, 2015
    Co-Authors: Anjail Z Sharrief, Lesli E Skolarus, Lynda D Lisabeth, Brisa N Sanchez, Nelda M Garcia, Darin B Zahuranec, Jonggyu Baek, Erin Case, Lewis B Morgenstern
    Abstract:

    Background: Fatalism and depression have been linked to post-stroke mortality and stroke recurrence. Our objective was to evaluate the impact of pre-stroke Fatalism, depressive symptoms, and social support on neurological, functional, and cognitive outcomes after stroke. Methods: Ischemic strokes (2008 -2011) were identified from the Brain Attack Surveillance in Corpus Christi (BASIC) Project. At baseline interviews, pre-stroke depressive symptoms, Fatalism, and social support were assessed using Patient Health Questionnaire (PHQ-9; 0-27; higher worse), modified Mental Adjustment for Stroke and Pearlin scales (8-40; higher worse), and a 7-item social support scale (0 -14; higher better); respectively. Outcome among survivors was assessed at 90 days using the National Institutes of Health Stroke Scale (NIHSS; 0-44, higher worse); activities/ instrumental activities of daily living (ADL/IADL; 1-4, higher worse); and Modified Mini-Mental State Exam (3MSE; 0-100, lower worse). Regression models were used to evaluate associations of interest, adjusting for demographic and clinical factors. Results: Among 364 participants with outcome interviews and complete covariate data, mean age was 66, 49.5% were female and 58.8% were Mexican American. In adjusted models, higher pre-stroke Fatalism (median 17; IQR 12, 20) was associated with poorer functional (0.17 point higher ADL/IADL score per IQR higher Fatalism score; 95% CI 0.05, 0.30) and cognitive (2.81 point lower 3MSE per IQR higher Fatalism score; 95% CI 0.95, 4.67) outcomes. Similarly, higher pre-stroke depressive symptoms (median 3; IQR 0, 9) were associated with poorer functional (0.16 point higher ADL/IADL per IQR higher PHQ-9; 95% CI .04, 0.28) and cognitive (2.28 point lower 3MSE per IQR higher PHQ-9; 95% CI 0.46, 4.10) outcomes. There were no significant associations between Fatalism or depressive symptoms and NIHSS or between social support (median 10; IQR 7, 12) and 90-day outcomes. Conclusions: Among ischemic stroke survivors, pre-stroke Fatalism and depressive symptoms, but not social support, impact 90-day functional and cognitive outcomes. These findings reinforce the importance of evaluating and addressing psychological factors in stroke care.

  • the prevalence of spirituality optimism depression and Fatalism in a bi ethnic stroke population
    Journal of Religion & Health, 2012
    Co-Authors: Lesli E Skolarus, Lynda D Lisabeth, Brisa N Sanchez, Melinda A Smith, Nelda M Garcia, Jan M H Risser, Lewis B Morgenstern
    Abstract:

    To provide insight into the reduced post-stroke all-cause mortality among Mexican Americans, we explored ethnic differences in the pre-stroke prevalence of (1) spirituality, (2) optimism, (3) depression, and (4) Fatalism in a Mexican American and non-Hispanic white stroke population. The Brain Attack Surveillance in Corpus Christi (BASIC) project is a population-based stroke surveillance study in Nueces County, Texas. Seven hundred ten stroke patients were queried. For Fatalism, optimism, and depression scales, unadjusted ethnic comparisons were made using linear regression models. Regression models were also used to explore how age and gender modify the ethnic associations after adjustment for education. For the categorical spirituality variables, ethnic comparisons were made using Fisher’s exact tests. Mexican Americans reported significantly more spirituality than non-Hispanic whites. Among women, age modified the ethnic associations with pre-stroke depression and Fatalism but not optimism. Mexican American women had more optimism than non-Hispanic white women. With age, Mexican American women had less depression and Fatalism, while non-Hispanic white women had more Fatalism and similar depression. Among men, after adjustment for education and age, there was no ethnic association with Fatalism, depression, and optimism. Spirituality requires further study as a potential mediator of increased survival following stroke among Mexican Americans. Among women, evaluation of the role of optimism, depression, and Fatalism as they relate to ethnic differences in post-stroke mortality should be explored.

  • Fatalism optimism spirituality depressive symptoms and stroke outcome a population based analysis
    Stroke, 2011
    Co-Authors: Lewis B Morgenstern, Lesli E Skolarus, Brisa N Sanchez, Melinda A Smith, Nelda M Garcia, Jan M H Risser, Darin B Zahuranec, Jeffrey J Wing, Lynda D Lisabeth
    Abstract:

    Background and Purpose— We sought to describe the association of spirituality, optimism, Fatalism, and depressive symptoms with initial stroke severity, stroke recurrence, and poststroke mortality. Methods— Stroke cases from June 2004 to December 2008 were ascertained in Nueces County, TX. Patients without aphasia were queried on their recall of depressive symptoms, Fatalism, optimism, and nonorganizational spirituality before stroke using validated scales. The association between scales and stroke outcomes was studied using multiple linear regression with log-transformed National Institutes of Health Stroke Scale and Cox proportional hazards regression for recurrence and mortality. Results— Six hundred sixty-nine patients participated; 48.7% were women. In fully adjusted models, an increase in Fatalism from the first to third quartile was associated with all-cause mortality (hazard ratio, 1.41; 95% CI, 1.06–1.88) and marginally associated with risk of recurrence (hazard ratio, 1.35; 95% CI, 0.97–1.88), but not stroke severity. Similarly, an increase in depressive symptoms was associated with increased mortality (hazard ratio, 1.32; 95% CI, 1.02–1.72), marginally associated with stroke recurrence (HR, 1.22; 95% CI, 0.93–1.62), and with a 9.0% increase in stroke severity (95% CI, 0.01–18.0). Depressive symptoms altered the Fatalism–mortality association such that the association of Fatalism and mortality was more pronounced for patients reporting no depressive symptoms. Neither spirituality nor optimism conferred a significant effect on stroke severity, recurrence, or mortality. Conclusions— Among patients who have already had a stroke, self-described prestroke depressive symptoms and Fatalism, but not optimism or spirituality, are associated with increased risk of stroke recurrence and mortality. Unconventional risk factors may explain some of the variability in stroke outcomes observed in populations and may be novel targets for intervention.

Susana A Ramirez - One of the best experts on this subject based on the ideXlab platform.

  • beyond Fatalism information overload as a mechanism to understand health disparities
    Social Science & Medicine, 2018
    Co-Authors: Susana A Ramirez, Kimberly Arellano Carmona
    Abstract:

    Abstract Background Fatalism – beliefs about the causes and controllability of disease – has been negatively associated with prevention behaviors. Fatalism has been suggested as a mechanism for health disparities because ethnic minorities are especially likely to hold fatalistic beliefs. However, the construct has been criticized: Fatalism fails to account for structural barriers to health faced by vulnerable populations that also score highly on measures of Fatalism. Another critique suggests that operationalizations of Fatalism expose communication failures: “Fatalism” rather reflects information overload from an environment riddled with misinformation and contradictions. This study aimed to expand understanding of one mechanism through which communication may contribute to disparities by considering the context of nutrition among bicultural Latinas, who face increased risk from dietary acculturation. Method Mixed-methods (semi-structured in-depth interview, survey) with Mexican-American women ages 18–29 (n = 24) in rural California. Results Contrary to previous studies, the majority of this sample of Mexican-American women did not endorse fatalistic beliefs; most demonstrated clear understanding of the link between diet and risk of diseases: Diabetes and heart disease were understood to result from behaviors within one's control. Yet despite articulating links between diet and disease, participants felt overloaded and confused about conflicting information from public and interpersonal sources. Moreover, despite reporting feeling inundated with information, participants noted critical information gaps, distinguishing between information available and information needed. Conclusions We found minimal support for fatalistic beliefs among a sample of Mexican-American women, but considerable information overload and confusion, together with a desire for specific knowledge and skills. Results extend understanding of how communication may influence disparities: Information overload may be conflated with Fatalism, challenging the notion that Fatalism is a cultural belief. Moreover, inequalities in access to and ability to process information compound overload effects. We discuss opportunities to improve the clarity of communication about nutrition science and dietary recommendations.

  • Fatalism and cancer risk knowledge among a sample of highly acculturated latinas
    Journal of Cancer Education, 2014
    Co-Authors: Susana A Ramirez
    Abstract:

    Fatalistic beliefs about cancer are associated with decreased likelihood of knowing about cancer risk factors and engaging in cancer prevention and screening behaviors. Research suggests that Latinas are especially likely to hold fatalistic beliefs. However, this research has been in less-acculturated, high-poverty convenience samples. This study examined cancer knowledge, cancer Fatalism, and the association between Fatalism and knowledge in a national sample of highly acculturated, middle-income Latinas (N = 715). Results indicate that cancer Fatalism is pervasive, and knowledge about cancer risk factors is lacking among this population. Fatalistic beliefs are paradoxically associated with cancer knowledge. Opportunities for tailored communications to improve health behaviors and additional research to understand causes/effects of these findings are discussed in the context of a growing body of research about how to communicate health information to more-acculturated Latinos.