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W194430635 abstract "Glioblastoma Multiforme: Geographic Variations in Tumor Size, Treatment Options, and Survival Rate by Susan Rebecca Nohelty MSN, Georgetown University, 1993 BSN, Columbia Union College, 1988 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University March 2015 Abstract Glioblastoma multiforme (GBM) is a destructive brain cancer that results in death 12 to 15 months after diagnosis. The purpose of this retrospective study was to determine if variations in tumor size at diagnosis, treatment options, and survival rate occur in GBM patients living in urban and rural areas of the United States. Using the behavior model of health services as the theoretical framework, this study used secondary data sets of GBM cases reported from 1988 to 2011 from the Surveillance, Epidemiology, and End Results program. Tumor size was measured in millimeters; treatment was evaluated by ascertaining the number of GBM patients who had surgical resection of their tumors, radiation, and chemotherapy; and survival rate was evaluated using Cox Regression analysis. With a sample size of 33,202 cases, data were examined using descriptive and multivariable analyses with SPSS. Results showed statistically significant differences in tumor size at diagnosis in rural patients compared to urban patients (p = 0.0085; p = 0.018), more urban patients were treated with radiation compared to rural patients (p < 0.001), and rural patients had poorer survival rates than urban patients (p < 0.001). Finally, when controlling for region, race, age, gender, education, and income, longer survival time was associated with urban status, female cases, and higher family income (p < 0.0001), and greater age was associated with reduced survival time (p < 0.0001). Study results could promote positive social change by identifying predictive variables associated with health outcomes of GBM patients. It may also educate providers on the risk of rurality of patients diagnosed with GBM, and inform lawmakers responsible for the creation of healthcare policy and the equitable allocation of healthcare resources.Glioblastoma multiforme (GBM) is a destructive brain cancer that results in death 12 to 15 months after diagnosis. The purpose of this retrospective study was to determine if variations in tumor size at diagnosis, treatment options, and survival rate occur in GBM patients living in urban and rural areas of the United States. Using the behavior model of health services as the theoretical framework, this study used secondary data sets of GBM cases reported from 1988 to 2011 from the Surveillance, Epidemiology, and End Results program. Tumor size was measured in millimeters; treatment was evaluated by ascertaining the number of GBM patients who had surgical resection of their tumors, radiation, and chemotherapy; and survival rate was evaluated using Cox Regression analysis. With a sample size of 33,202 cases, data were examined using descriptive and multivariable analyses with SPSS. Results showed statistically significant differences in tumor size at diagnosis in rural patients compared to urban patients (p = 0.0085; p = 0.018), more urban patients were treated with radiation compared to rural patients (p < 0.001), and rural patients had poorer survival rates than urban patients (p < 0.001). Finally, when controlling for region, race, age, gender, education, and income, longer survival time was associated with urban status, female cases, and higher family income (p < 0.0001), and greater age was associated with reduced survival time (p < 0.0001). Study results could promote positive social change by identifying predictive variables associated with health outcomes of GBM patients. It may also educate providers on the risk of rurality of patients diagnosed with GBM, and inform lawmakers responsible for the creation of healthcare policy and the equitable allocation of healthcare resources. Glioblastoma Multiforme: Geographic Variations in Tumor Size, Treatment Options, and Survival Rate by Susan Rebecca Nohelty MSN, Georgetown University, 1993 BSN, Columbia Union College, 1988 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University March 2015 Dedication This dissertation is dedicated to two very special people in my life: my sister, Doll, and my husband, Jim. My sister, Doll, courageously and tenaciously fought to beat the dismal odds of Glioblastoma Multiforme. Although she eventually succumbed to this disease in October 2011, she left a lasting legacy of hope and inspiration to her family and friends who loved her. This dissertation would not have been possible without the love and support from my husband, Jim (affectionately known as Dude). He wholeheartedly supported my dream of earning a PhD; in fact, my dream became his dream. He took over all responsibilities of running a household, kept the home fires burning, and spent many evenings and weekends alone. All I had to do was worry about work during the day and course work at night and on weekends. Dude, you are my best friend, my confidante, and the most special love of my life. Acknowledgments First and foremost, I would like to give thanks to the chair of my dissertation committee, Dr. Hadi Danawi, for his never-ending support throughout this dissertation journey. Second, I would like to extend heartfelt appreciation to my second committee member, Dr. Richard Jimenez, and University Research Reviewer, Dr. James Rohrer. All three of these academic professionals shared their collective expertise so that I could create a quality product, and realize my dream of earning a PhD. Third, I’d like to thank my Form and Style Editor, Dayna Herrington, for her invaluable skill, expertise and guidance. Finally, I am forever grateful to Walden University and the many professionals who helped me throughout this entire academic journey." @default.
W194430635 created "2016-06-24" @default.
W194430635 creator A5005506931 @default.
W194430635 date "2015-01-01" @default.
W194430635 modified "2023-09-27" @default.
W194430635 title "Glioblastoma Multiforme: Geographic Variations in Tumor Size, Treatment Options, and Survival Rate" @default.
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