Objective: This study explores the unmet psychosocial rehabilitation needs of cancer survivors.Methods: Sixty-eight cancer survivors from the Shanghai Cancer Rehabilitation Club in China participated in one of the eight focus groups. These were transcribed verbatim, coded using thematic analysis and analysed using NVivo 10.Results: Five main themes were identified: the need for (1) better information: Chinese cancer survivors find it difficult to sort and evaluate the overwhelming mass of information with which they are confronted; (2) psychological support: survivors fear cancer relapse and neighbours' discrimination against them; support from other cancer survivors can relieve the stress; (3) support for survivors' families: like the survivors, family members are under great but usually unacknowledged pressure; (4) improved health and medical services: community health service centres provide little medical, informational or psychological support for cancer survivors, who seek and expect more communication with doctors; and (5) assistance with the financial burden: costs of treatment and lack of adequate medical insurance cause substantial financial pressure for survivors.Conclusions: This study shows that, in addition to their illness, Chinese cancer survivors experience a range of stresses related to their financial circumstances, lack of reliable and summarised information, poor access to support and services (including for their families) and discrimination. Support from families seems to improve survivors' ability to cope. Cancer survivors (and their families) need an integrated package of support from their families, doctors and other service providers, hospitals and communities. These findings can inform approaches to continuing care for cancer survivors.
AbstractsBackgroundHypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China’s elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai’s communities.MethodsA secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai.ResultsOf the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants’ median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m2). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities.ConclusionsThe prevalence of hypertension was high in China’s elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.
The psycho-social support activities of SCRC had influenced cancer survivor's life. Public health resources and supportive policies should be in place to support local self-help cancer rehabilitation groups.
BackgroundIn the People’s Republic of China, both western medicine (WM) and traditional Chinese medicine (TCM) are the main treatment and rehabilitation options for cancer patients. This study aimed to explore cancer survivors’ perspectives and experience of treatment and rehabilitation, in order to promote patient-centered activities of treatment and rehabilitation.MethodsUsing a qualitative research approach, 68 cancer survivors were recruited from eight community cancer rehabilitation organizations in Shanghai, People’s Republic of China. Eight focus group interviews were conducted. All these interviews were transcribed verbatim, and the data were analyzed by theme analysis.ResultsWM was the main choice in treatment phase though study participants noted more side effects. TCM was primarily used in the recovery phase. The lack of communication between doctors and cancer patients appears to affect treatment adherence and impair the doctor–patient relationship. WM was expensive for diagnostic procedures and treatment, while the cumulative costs of frequent use of TCM in the long rehabilitation period were also high. Both treatment options created significant perceived economic burden on patients. Conflicting information about dietary supplements tended to make cancer survivors confused.ConclusionImproving the communication between doctors and cancer patients helps to ameliorate cancer patient adherence and the effect of treatments. It is essential to educate cancer patients about the effect and cost of both WM and traditional TCM. Meanwhile, marketing management and guidance to consumers regarding use of dietary supplements in the cancer rehabilitation field are also necessary.
TB control supporting partners in the country, should improve training of all the health workers on TB control services.http://dx. Background:Under the fast urbanization, Shanghai is hosting more and more domestic rural-to-urban migrants who do not have a certified local residence. Tuberculosis is more prevalent in rural population in China. In 2014, non-residential population has accounted for 42.9% of new pulmonary tuberculosis (PTB) patients in Shanghai. Close contacts of non-residential patients are at high risk of latent tuberculosis infection (LTBI). This study aimed to understand the prevalence of LTBI in close contacts of nonresidential PTB patients, and to identify the risk factors associated with LTBI in Shanghai. Methods & Materials:A cross-sectional study was conducted among close contacts of non-residential PTB patients diagnosed in 2013-2014 in 4 districts of Shanghai. T-SPOT.TB was applied to detect the LTBI among contacts, together with a questionnaire for collecting information on demographics, socio-economic status, history of Bacille Calmette-Gueŕin (BCG) vaccination, symptoms of TB and details of contacting. The status of LTBI was defined as T-SPOT.TB positive plus no TB symptoms and a normal lung image by chest X-ray.Results: In this study, 460 close contacts were self-reported by 226 registered PTB patients. Of these contacts, 43.0% were male and 58.0% were BCG vaccinated. Overall, 83 contacts had positive T-SPOT.TB results without TB symptoms, which presented an 18.0% (95%CI: 14.5%∼21.6%) prevalence of LTBI. The prevalence of LTBI increased with age (X 2 liner trend =3.910, p=0.048), and exposure duration to PTB patients (X 2 liner trend =6.401, p=0.011). Stratified analysis by age (0-19, 20-39, 40-59, and ≥60 years) indicated that the association between LTBI prevalence and exposure duration was statistically significant at the age of 20-39 years (X 2 liner trend =4.947, p=0.026). Multivariate analysis showed that household contact significantly increased the risk of LTBI (aOR=9.030, 95%CI: 2.568-31.756); and contacts of PTB patients having cough (aOR=2.541, 95%CI: 1.258-5.133) and cavities in lung (aOR=1.698, 95%CI: 1.008-2.860) were more likely to be LTBI than those otherwise.Conclusion: Close contacts of non-residential PTB patients had a relatively high LTBI prevalence. Intervention for infection control among PTB close contacts should be concerned in the policy development for ending TB in 2035 in Shanghai.
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