Assessment
Accurate patient assessment is essential for the effective management of pain and also plays a critical role in identifying potential abuse problems. The American Pain Society (APS) guidelines set three main goals for pain assessment:
INTRODUCTION
The National Medical Association (NMA) is the largest and oldest national organization representing African-American physicians and health professionals in the United States. Established in 1895, the NMA represents more than 25,000 African-American physicians and the patients they serve. Through its membership, professional development, community health education, advocacy, research, and its efforts with federal and private agencies and corporations, the NMA is committed to improving the health status and outcomes of minority and disadvantaged people. While throughout its history, the National Medical Association has focused primarily on health issues related to African Americans and medically underserved populations, its principles, goals, initiatives, and philosophy encompass all sectors of the population.
Education includes not only knowledge acquisition but also the ability to retain the knowledge learned, resulting in effective daily application of the knowledge acquired. We have demonstrated that CAPP is effective in teaching basic principles of asthma to an urban, African-American population residing in a low-income community. Once the participants have acquired this knowledge, they are able to retain most of the knowledge acquired for up to one year postinstruction. This postinstructional change was also seen in parents’ perception of asthma control and asthma quality of life. The delay seen in the rise of the parents perception of asthma control and quality of life to the same level of significance found immediately postinstruction with asthma knowledge may be explained by the process of applying knowledge obtained before seeing outcomes in daily life. In some cases, the benefits lasted for up to a year.
Participants
All respondents were African-American parent/ caregivers (Table 2). Three-hundred-forty-two adult participants enrolled, and 267 completed at least four out of five classes as well as the prepost assessments at the beginning and end of classes. Seventy-five percent of the 267 participants responded to the telephone assessments at three- and six-month follow-up, and 50% responded to the 12 month follow-up telephone assessment. No differences were found in age, educational level, or gender in the participants who dropped out.
Study Design
The present study was a convience sample survey carried out in community-based classes for children’s asthma. Parents of children with asthma were surveyed at baseline and immediately after the classes. Follow-up assessments were made at three-, six-, and 12 months post instruction. There was no control group, because the primary goal of this outreach effort was to educate as many community residents as possible about asthma and to study whether this effort provided effective education for the participants. The prepost design allowed every participant to be his or her own control.
Asthma is a chronic inflammatory disease of the lungs that affects approximately 17 million Americans, five million of whom are children under the age of 14 years old. Minorities, particularly urban African Americans living in poverty, are disproportionately affected. The severity of disease is increasing, despite the improved knowledge in asthma cause and treatment. A telephonic survey conducted every two years reveals that the prevalence for African American residents in Philadelphia is about 14%, whereas the general population is about 7.5%.
This study identified predisposing and program intervention factors that influence African-American men’s participation in prostate cancer screening. The predisposing factors were labeled using the constructs of existing health behavior theories. The most important findings in this study were the personal statements of the participants which reflect their true feelings. A major predisposing factor identified in the study was impediments to prostate cancer screening. Nonethnographical studies that have found perceived barriers to significantly impact prostate cancer screening include that of Shelton et al., Eisen et al., Weinrich et al., and Merrill. In our study, examples of impediments noted by the participants were lack of access to healthcare, discomfort of the digital rectal examination, not trusting the healthcare system or the healthcare provider, black men not seeing doctors regularly, not receiving information from the doctor, not having a primary care doctor, not having a black doctor, illiteracy, lack of self-motivation, not wanting to appear “too white,” services mostly provided by white physicians, having other priorities, and “powerless-ness” because African-American men are noted to be at risk for many diseases. In another ethnographical study, digital rectal exam embarrassing and uncomfortable, was listed as a barrier by African-American men as influencing their behavior. Regardless of whether these impediments are real or perceived, overcoming them will be significant in increasing prostate cancer screening in African-American men. On the opposite end, prostate cancer screening facilitators identified by participants were easier procedures for testing, testing required by employer, free screening, access to healthcare, transportation, and reminders from physicians.
© 2008 HIV/AIDS News & Information