PURPOSE: To identify predictive factors of adherence to medical advice, specifically the likelihood of attendance to a recommended follow-up regimen in patients with newly diagnosed testicular cancer. PATIENTS AND METHODS; This was a prospective study measuring initially not only aspects of the doctor-patient interview, but also a range of demographic, psychological, social, and medical factors, and then recording attendance behavior on follow-up. All 209 new patients with testicular cancer referred between June 1992 and May 1995 were approached, and 184 men consented and completed questionnaires. The nonadherence end point (nonattender) was two failures to attend an outpatient appointment at least 1 month apart, despite a written reminder. RESULTS: Thirty-two participants (17%) were classified as nonattenders. No significant differences were found between attenders and nonattenders in the majority of psychosocial and medical variables that might have predicted nonadherence to medical advice. There was a highly significant association between nonattendance and a patient's perception of an unsatisfactory affective relationship with his clinician (P = .005; hazard ratio, 3.1; 95% CI, 1.4 to 6.6). CONCLUSION: Patients who perceived an unsatisfactory affective relationship with their clinician that included an inability to trust the clinician and a perception that they were not being treated as "a person" were subsequently more likely to disregard medical advice regarding follow-up. Attention to the ways young men may wish to communicate with their clinicians is important, bearing in mind that they may not necessarily adhere to stereotypical images of masculine self-dependence.
PURPOSE: To identify predictive factors of adherence to medical advice, specifically the likelihood of attendance to a recommended follow-up regimen in patients with newly diagnosed testicular cancer. PATIENTS AND METHODS; This was a prospective study measuring initially not only aspects of the doctor-patient interview, but also a range of demographic, psychological, social, and medical factors, and then recording attendance behavior on follow-up. All 209 new patients with testicular cancer referred between June 1992 and May 1995 were approached, and 184 men consented and completed questionnaires. The nonadherence end point (nonattender) was two failures to attend an outpatient appointment at least 1 month apart, despite a written reminder. RESULTS: Thirty-two participants (17%) were classified as nonattenders. No significant differences were found between attenders and nonattenders in the majority of psychosocial and medical variables that might have predicted nonadherence to medical advice. There was a highly significant association between nonattendance and a patient's perception of an unsatisfactory affective relationship with his clinician (P = .005; hazard ratio, 3.1; 95% CI, 1.4 to 6.6). CONCLUSION:Patients who perceived an unsatisfactory affective relationship with their clinician that included an inability to trust the clinician and a perception that they were not being treated as "a person" were subsequently more likely to disregard medical advice regarding follow-up. Attention to the ways young men may wish to communicate with their clinicians is important, bearing in mind that they may not necessarily adhere to stereotypical images of masculine self-dependence.
Authors: H G Taylor; A W Brown; W M Butler; M D Weltz; J L Berenberg; D G McCleod; J E Fowler; R E Stutzman; J Blom Journal: Cancer Date: 1981-09-01 Impact factor: 6.860
Authors: June A Peters; Regina Kenen; Lindsey M Hoskins; Gladys M Glenn; Christian Kratz; Mark H Greene Journal: Hered Cancer Clin Pract Date: 2012-03-01 Impact factor: 2.857
Authors: Friedemann Zengerling; Michael Hartmann; Axel Heidenreich; Susanne Krege; Peter Albers; Alexander Karl; Lothar Weissbach; Walter Wagner; Jens Bedke; Margitta Retz; Hans U Schmelz; Sabine Kliesch; Markus Kuczyk; Eva Winter; Tobias Pottek; Klaus-Peter Dieckmann; Andres Jan Schrader; Mark Schrader Journal: Oncol Rep Date: 2014-04-24 Impact factor: 3.906
Authors: J Beyer; P Albers; R Altena; J Aparicio; C Bokemeyer; J Busch; R Cathomas; E Cavallin-Stahl; N W Clarke; J Claßen; G Cohn-Cedermark; A A Dahl; G Daugaard; U De Giorgi; M De Santis; M De Wit; R De Wit; K P Dieckmann; M Fenner; K Fizazi; A Flechon; S D Fossa; J R Germá Lluch; J A Gietema; S Gillessen; A Giwercman; J T Hartmann; A Heidenreich; M Hentrich; F Honecker; A Horwich; R A Huddart; S Kliesch; C Kollmannsberger; S Krege; M P Laguna; L H J Looijenga; A Lorch; J P Lotz; F Mayer; A Necchi; N Nicolai; J Nuver; K Oechsle; J Oldenburg; J W Oosterhuis; T Powles; E Rajpert-De Meyts; O Rick; G Rosti; R Salvioni; M Schrader; S Schweyer; F Sedlmayer; A Sohaib; R Souchon; T Tandstad; C Winter; C Wittekind Journal: Ann Oncol Date: 2012-11-14 Impact factor: 32.976