Improvement in the communication among parents, school nurses, and providers is critical to the improvement of asthma management for children in high-risk school districts.
Objectives. Physicians are seeing increasing numbers of parents who question the safety of vaccines or refuse to vaccinate their children. This study examined how frequently pediatricians in one New England state encounter parental vaccine safety concerns and vaccine refusals, how often physicians dismiss families from their practices for vaccine refusal, and how parental vaccine refusal impacts pediatricians personally.
BACKGROUND:
Data from the 1998 Health Outcomes Survey (HOS) of patients who were enrolled in Medicare managed care and follow‐up data from the 2000 HOS resurvey were analyzed to examine changes in health‐related quality of life (HRQOL) of newly diagnosed cancer patients, cancer survivors, and patients without cancer.
METHODS:
In 1998, the HOS was mailed to a random sample of 279,135 beneficiaries, and 167,096 respondents (60%) returned completed surveys. Those who were diagnosed with cancer (22,747) were frequency age‐matched to an equal number of patients with no cancer. In 2000, the HOS was mailed to the same cohort of beneficiaries. Complete data at both baseline and follow‐up were available on 16,850 individuals for inclusion in the current study.
RESULTS:
After 2 years, respondents who had been diagnosed with cancer at baseline continued to have lower scores on all but 3 scales of the 36‐item short‐form HRQOL measure. However, there was no evidence that they were declining any faster than or catching up with noncancer patients. Those who had been newly diagnosed with cancer since the baseline survey had lower mean scale scores than the no‐cancer group on all scales and lower mean scores than the cancer survivors on all subscales except Bodily Pain, Vitality, and Mental Health.
CONCLUSIONS:
This study demonstrated that, after 2 years, cancer survivors continued to have poorer HRQOL than the no‐cancer group. Newly diagnosed cancer patients had poorer quality of life than both the longer term cancer survivors and the no‐cancer group. Cancer 2009. Published 2009 by the American Cancer Society*.
Our preliminary data indicate that this CCIQ is a promising tool in assessing QoL specific to CI2 patients. Overall, patients reported improved QoL, independent of speech perception scores. Further refinements of the questionnaire with larger patient numbers are needed to strengthen the CCIQ.
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