OBJECTIVES: An integrative literature review was undertaken to explore existential concerns among patients with cancer with respect to components, related concepts and targets of interventions. METHODS: Comprehensive searches in MEDLINE, CINAHL, PsychINFO, Social Citation Index, SweMed+, Eurethics, NLM Gateway, Faculty of 1000 Medicine, Cochrane Library, EMBACE were undertaken. Each paper was read and classified according to design as descriptive qualitative, descriptive quantitative or interventional. Main themes, interventions and outcomes were identified. RESULTS: The searches yielded a total of 162 articles, of which 109 met inclusion criteria. Existential components from the qualitative studies were divided into two main themes: struggle to maintain self-identity and threats to self-identity. Quantitative studies mainly concerned relationships between existential concerns and other concepts. Interventions and assessed outcomes were consistent with components and relationships found in the descriptive studies. Relationships concerned physical and psychological domains; however, few interventions were evaluated against physical outcomes. No interventions applicable to everyday health-care practice were found. CONCLUSION: Interventions targeted and evaluated concepts related to existential concerns found in the descriptive studies. Gaps in research on existential concerns in patients with cancer include the need to clarify the concept; how patients' existential well-being may best be supported by health-care professionals in everyday practice; effects of existential interventions on physical symptoms; and stability of results of interventions.

Existential concerns among patients with cancer and interventions to meet them: an integrative literature review.

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Handbook of Alcoholism Treatment Approaches: Effective Alternatives

Objective: Close interpersonal relationships play a crucial role in a woman's adjustment to breast cancer. To date, the literature has focused primarily on characteristics or behaviors of the well spouse that influence a woman's adaptation to the illness. The present qualitative investigation extended this literature by adopting an interactional perspective based on the underlying assumption that relationship partners' coping and distress is mutually influential. The focus of the analysis was patient and partner perceptions of relationship strife or tension over the course of the illness based on the notion that such interactions may be as or more harmful to relationships than supportive exchanges are helpful.



Method: Nineteen women (at different stages of the illness) and eleven male spouses were interviewed about their experiences in relation to breast cancer. Nine of the men and nine of the women were relationship partners. Interview text was subjected to a thematic analysis and informed by grounded theory principles.



Results: Two higher-order categories of Personal Characteristics (both patient and partner) and Relationship Dynamics that impeded couple adjustment defined the overall theme of Relationship Vulnerabilities.



Conclusions: Findings from this study are situated within a broader developmental framework wherein breast cancer is considered a catastrophic life event that challenges the assimilation and accommodation processes of both partners in the relationship. For couples that are able to overcome the relationship challenges associated with the illness, there is the potential for mutual growth, and a deepening and strengthening of the relationship. Implications for clinical practice are discussed. Copyright © 2009 John Wiley & Sons, Ltd.

Relationship vulnerabilities during breast cancer: patient and partner perspectives.

Maternal substance use and child protection: a rapid evidence assessment of factors associated with loss of child care

The role of substance use in child welfare caseloads

This study examines the reunification outcomes of 4 groups of children placed in foster care in Oklahoma: those referred due to parental alcohol-only abuse, those due to parental drug-only abuse, those with both alcohol and drug involvement, and those with neither alcohol nor drug involvement. Following bivariate analysis to examine group differences, survival analysis was utilized to predict reunification rates. Overall, differences in time to reunification among the 4 groups were significant. The neither alcohol nor other drug group was significantly different from the other 3 groups, but the alcohol-only group was different from the groups that included any drug involvement.

Parental substance abuse and family reunification.

An existential approach to the treatment of couples facing breast cancer, as well as qualitative themes describing the central clinical concerns of the couples in treatment, is outlined and described. In addition, a descriptive clinical study that reviews the changes made by 27 couples facing breast cancer treated by the first author between 1978 and 1998 is also outlined and described. A non-parametric test was used to determine that changes in scores on two clinical measures were significant, suggesting the usefulness of the presented existential clinical approach.

Existential Psychotherapy with Couples Facing Breast Cancer: A Twenty Year Report

Substance use behaviors by parents and the decision to substantiate child physical abuse and neglect by caseworkers

Existential psychotherapy with Vietnam combat veteran couples should include the treatment elements of holding, telling, mastering, and honoring the combat trauma pain. The authors describe these four treatment elements and provide a descriptive clinical study of this treatment approach with 53 Vietnam veteran couples treated by the first author between 1974 and 1999. All 53 couples made good progress during treatment, as indicated by self-report and two clinical measures of marital adjustment.

Existential psychotherapy with vietnam veteran couples : A twenty-five year report

An existential trauma therapy treatment approach with men who are recovering from a heart attack is described as well as the treatment elements within the approach. Single-subject design case material is provided to evaluate and illustrate the described treatment approach.

Tom Gregoire

Papers

Parental substance abuse and family reunification.

Existential Psychotherapy with Couples Facing Breast Cancer: A Twenty Year Report

Substance use behaviors by parents and the decision to substantiate child physical abuse and neglect by caseworkers

Existential psychotherapy with vietnam veteran couples : A twenty-five year report

Existential Trauma Therapy with Men After a Heart Attack