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Can health beliefs help in explaining attendance to follow-up care? The Swiss childhood cancer survivor study


Michel, G; Kuehni, C E; Rebholz, C E; Zimmermann, K; Eiser, C; Rueegg, C S; von der Weid, N X; Grotzer, M; Niggli, F K (2011). Can health beliefs help in explaining attendance to follow-up care? The Swiss childhood cancer survivor study. Psycho-Oncology, 20(10):1034-1043.

Abstract

OBJECTIVE:

Improved treatment has increased the survival of childhood cancer patients in recent decades, but follow-up care is recommended to detect and treat late effects. We investigated relationships between health beliefs and follow-up attendance in adult childhood cancer survivors.
METHODS:

Childhood cancer survivors aged younger than 16 years when diagnosed between 1976 and 2003, who had survived for more than 5 years and were currently aged 20+ years, received a postal questionnaire. We asked survivors whether they attended follow-up in the past year. Concepts from the Health Belief Model (perceived susceptibility and severity of future late effects, potential benefits and barriers to follow-up, general health value and cues to action) were assessed. Medical information was extracted from the Swiss Childhood Cancer Registry.
RESULTS:

Of 1075 survivors (response rate 72.3%), 250 (23.3%) still attended regular follow-up care. In unadjusted analyses, all health belief concepts were significantly associated with follow-up (p<0.05). Adjusting for other health beliefs, demographic, and medical variables, only barriers (OR=0.59; 95%CI: 0.43-0.82) remained significant. Younger survivors, those with lower educational background, diagnosed at an older age, treated with chemotherapy, radiotherapy, or bone marrow transplantation and with a relapse were more likely to attend follow-up care.
CONCLUSIONS:

Our study showed that more survivors at high risk of cancer- and treatment-related late effects attend follow-up care in Switzerland. Patient-perceived barriers hinder attendance even after accounting for medical variables. Information about the potential effectiveness and value of follow-up needs to be available to increase the attendance among childhood cancer survivors.

2010 John Wiley & Sons, Ltd.

Abstract

OBJECTIVE:

Improved treatment has increased the survival of childhood cancer patients in recent decades, but follow-up care is recommended to detect and treat late effects. We investigated relationships between health beliefs and follow-up attendance in adult childhood cancer survivors.
METHODS:

Childhood cancer survivors aged younger than 16 years when diagnosed between 1976 and 2003, who had survived for more than 5 years and were currently aged 20+ years, received a postal questionnaire. We asked survivors whether they attended follow-up in the past year. Concepts from the Health Belief Model (perceived susceptibility and severity of future late effects, potential benefits and barriers to follow-up, general health value and cues to action) were assessed. Medical information was extracted from the Swiss Childhood Cancer Registry.
RESULTS:

Of 1075 survivors (response rate 72.3%), 250 (23.3%) still attended regular follow-up care. In unadjusted analyses, all health belief concepts were significantly associated with follow-up (p<0.05). Adjusting for other health beliefs, demographic, and medical variables, only barriers (OR=0.59; 95%CI: 0.43-0.82) remained significant. Younger survivors, those with lower educational background, diagnosed at an older age, treated with chemotherapy, radiotherapy, or bone marrow transplantation and with a relapse were more likely to attend follow-up care.
CONCLUSIONS:

Our study showed that more survivors at high risk of cancer- and treatment-related late effects attend follow-up care in Switzerland. Patient-perceived barriers hinder attendance even after accounting for medical variables. Information about the potential effectiveness and value of follow-up needs to be available to increase the attendance among childhood cancer survivors.

2010 John Wiley & Sons, Ltd.

Citations

8 citations in Web of Science®
9 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:11 Mar 2012 08:46
Last Modified:05 Apr 2016 15:43
Publisher:Wiley-Blackwell
ISSN:1057-9249
Publisher DOI:https://doi.org/10.1002/pon.1823
PubMed ID:20687196

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