Showing papers in "Journal of Psychosocial Oncology in 1992"

Predictors of Strain in Families of Cancer Patients

Abstract: This review of Ule research litcrature on family adjustmenl to canccr idcntifics thc factors that consistently predict the extent of psychosocial problems experienced by family members. A conceptual model was applied that viewed the degree of family strain as being determined by two sets of variables: the objective factors of the illness itself and family context variables. With regard to objective factors, Ule degree of family strain is affected primarily by the severity of the illness as well as by the suddenness of its onset and the patient's own level of distress. In addition, such contextual variables as thc age, gender, and health of family members. Their other life stressors and previous psychological problems, family stage and relational bonds, and social supports of family members also conlribute to the psychosocial impact of illness on the family.

Factors Associated with Cancer Patients' Participation in Support Groups

Abstract: This study examined the participation in two support groups of 154 cancer patients treated at a large cancer center. The factors hypothesized to influence participation at monthly meetings were (1) demographic characteristics, (2) extent of participation in other voluntary associations, (3) help-seeking behavior, (4) availability of social support from family and friends, and (5) geographic distance from the hospital. Those most likely to participate were educated, younger, unmarried, "joiners" of other voluntary associations, and help seekers who had consulted mental health professionals. Geographic distance from the hospital was not a barrier to group participation. Social support had a complex relationship to participation. Patients with inadequate social support were especially likely to participate, but patients with high scores on family support and cohesiveness were most likely to attend. Open-ended interviews revealed that the participants' major motivations for attending were to compare their own...

Effects of Psychosocial Support on Patients with Metastatic Breast Cancer

Abstract: This article reviews evidence that psychosocial support may influence the progression of cancer, as indicated by differences in length of survival. Psychotherapeutic methods that have proved to be effective involve direct confrontation of fears; expression of affect, including aegative feelings; provision of social support; and training in self-hypnosis for analgesia. Possible mechanisms for this psychosocial effect on progression of disease include changes in diet and exercise, better use and provision of health care, and positive effects on the sensitivity of the endocrine and immune systems to stress. The author reviews the limitations of these theories and offers suggestions for future research.

Family communication and coping with cancer: Impact of the We Can Weekend.

Abstract: This study was designed to (1) explore the role of communication in family coping and (2) assess the impact of a weekend intervention designed to enhance communication in families experiencing cancer. Data were collected from 14 families participating in a weekend retreat program (The Massachusetts We Can Weekend). Those families who communicated frequently and used a variety of coping strategies reported less difficulty coping with cancer than did those who used fewer strategies. Although the findings are limited, they suggest that participating in interventions such as the We Can Weekend can enhance family members' ability to cope by increasing their use of communication and social support.

The "Bear Essentials" Program

Abstract: Although an increasing number of cancer patients are living with their disease, a hidden group at high risk for psychological problems are their children. To address this situation, a pilot project called "Bear Essentials" was developed at Missouri Baptist Cancer Center in St. Louis for young children of cancer patients to help families (1) understand how children perceive illness, separation, and loss, (2) discuss the concerns of patients, spouses, and children in a supportive environment, and (3) develop coping strategies to manage better the emotional difficulties caused by a parent's illness. Children and parents met separately in concurrent monthly support groups led by a team composed of a social worker, nurses, and a chaplain. This article examines the literature on the children of cancer patients, describes the process of developing the project, and discusses the content, assessment, and outcomes of the project, which has become an ongoing program. It concludes with recommendations for replication...

Development of the Satisfaction with Life Domains Scale for Cancer

Abstract: This article describes the development of the Satisfaction with Life Domains Scale for Cancer (SLDS-C), a self report instrument for assessing the subjective quality of life of patients receiving aggressive cancer treatment. The SLDS-C asks respondents to rate their satisfaction with 17 areas of life using seven faces (three smiling, one neutral, and three frowning). The instrument has the following advantages: it is acceptable to patients, is easily understood, and allows different degrees of either positive or negative responses. The authors present evidence of the reliability and validity of the scale on the basis of the responses of 109 long-term cancer survivors who had received bone marrow transplants.

Intimacy and Sexuality After Cancer Treatment

Abstract: All cancers affect body image and self-image and thus have the potential to diminish sexual functioning and feelings of sexual attractiveness. Nevertheless, patients and health care professionals often avoid discussions about changes in sexual functioning and intimacy. The oncology social worker is in a unique position to use a portion of the routine biopsychosocial assessment to inquire about changes in sexual functioning and intimacy. The authors review the common psychosocial problems associated with these changes, the timing of the assessment, the oncology social worker's role, and approaches to intervention with patients and their partners. In addition, they provide two case examples to illustrate these approaches.

Interpersonal Communication and Psychosocial Adjustment

Abstract: Cancer patients receiving radiation therapy (N = 102) were interviewed to obtain self-report data concerning the relationships between patient-family communication and psychosocia1 adjustment to illness. Psychosocial adjustment was tapped with the Psychosocial Adjustment to Illness Scale. Data analysis revealed that interactions with family members were important in determining whether a patient had adjusted effectively. Multiple discriminant analysis procedures revealed that frequency of interactions and emotional support provided in the interactions were important discriminating variables of effective adjustment. Surprisingly, honesty and discussion of unpleasant topics were not identified as important discriminating variables. The data suggested that communicating with significant others about the disease in an emotionally supportive environment was conducive to effective adjustment.

Marital Quality and Quality of Life Among Cancer Patients and Their Spouses

Abstract: Research on the quality of life of cancer patients has stressed the significance of social support from their marital relationship. In this study, patients and spouses were asked to assess their current marital relationship and how they remembered it as being before the cancer diagnosis. Marital quality was assessed by interactional style, level of intimacy, and coping with problems. Personality was assessed by measuring stage of ego development: preconformist, conformist, and postconformist. The study produced two major findings. First, affiliation with the spouse had the highest correlation with the patients' quality of life, whereas coping with problems had the highest correlation with the spouses' quality of life. Second, patients who were at the postconformist stage of ego development were most likely to report that their marital relationship had become stronger over the course of their illness. The study carries implications for the structuring of differential psychosocial interventions for patients...

Work-Related Stress Specific to Physicians and Nurses Working with Cancer Patients

Abstract: This article describes a study comparing the work related stress experienced by physicians and nurses working with cancer patients and by those working with patients in cardiac, intensive care, or surgical units. Stress was measured with a newly developed questionnaire containing one question for each of 64 potentially stressful situations; each question was to be answered according to the relevance and degree of emotional or physical stress caused by each situation. The respondents were 299 physicians and 592 nurses from 54 different hospilals and clinics. Although the oncology and corn arison groups experienced the same overall degree of work-relate (stress and physical complaints, the oncology group suffered more from feellngs of emotional involvement and selfdoubt. However, they suffered less from stress connected with institutional factors than did the comparison group dcspite few objective differences in their situalions. Differences in patterns of coping and subjective perceptions of stress may exp...

Association Between Personality Characteristics and the Prevalence and Extinction of Conditioned Nausea After Chemotherapy

Abstract: The prevalence and correlates of conditioned nausea were evaluated in 39 relapse-free men 13 to 75 months after completion of chemotherapy for testicular cancer. Two-thirds (26) of the patients reported this conditioned side effcct during thc first 12 months after treatment, and fewer than half (16) reported it for more than 12 months. Relatively high autonomic perceptivity and neuroticism were associated with both the prevalence and slow extinction of conditioned nausea. A history of motion sickness was linked to this conditioned side effect, and extroversion was related only to its prevalence. Patients who had experienced conditioned nausea had received a greater number of chemotherapy cycles, and those with persistent nausea also reported more profound vomiting during chemotherapy. Antiemetic - treatment with highdose metoclopramide during chemotherapy did not prevent development of conditioned nausea but did tend to contribute to its faster extinction.

Psychosocial Impact of Gynecologic Cancer

Abstract: Thirty-two women with gynecologic cancer who had been treated with a radical hysterectomy, a vulvectomy, or total pelvic exenteration and were currently disease-free were studied. The patients' average score on the Functional Living Index-Cancer was 124; that is, most reported a good quality of life. Their scores on the SCL-90-R reflected moderately elevated levels of psychological distress that were comparable to levels of breast cancer patients who had participated in an earlier study. The authors found a strong negative correlation (r = -.64) between age and sychological distress; younger patients appeared to be more at risk for psychological problemm after radical gynecologic surgery.

The Impact of Secrets in Hemophilia and HIV Disorders

Abstract: Hemophilia, which had become a manageable chronic illness in the 1970s with the advent of coagulant factor concentrates, became a condition often shrouded in fear, isolation, and secrecy in the 1980s with the advent of HIV infection and AIDS. To help hemophiliac patients and their families manage the hemophilia and HIV infection, treatment providers must be aware of the variety of secrets that may have an impact on patients, parents, and the health care learn. Some secrets, if not properly managed, may interfere with optimal medical care and the patient's subsequent emotional adjustment. Because secrets and their sequelae often become increasingly complicated over time, the authors use two case examples to illustrate the potential ethical, practical, moral, and legal difficulties that can arise.

Spirituality and the Child

Abstract: This article discusses dala obtained from interviews with 56 children aged 8 to 12 years from six schools in Adelaide, South Australia, and 38 parents after a grandparent's death. It also explores the idea that when someone close to a child dies, adults have an opportunity to help the child understand and address spiritual concerns concerning the death. The children were asked questions about (1) their relationship with the grandparent before the death, (2) how they learned of the death, and (3) their mourning rituals and reactions. An analysis of these data revealed hat many of the children's comments seemed surprisingly slraightforward and mature, suggesting a level of insight and self-awareness not usually attributed to children, whereas the parents' comments revealed a lack of awareness regarding their children's thoughts and feelings about the death. The author concludes bat adults who share thcir insecurities or hesitancies with children, acknowledge their inability to alleviate all the discomfort s...

Factors Affecting Survival and Satisfaction

Abstract: This article consists of four parts. First, the authors review the literature on factors that affect job satisfaction and longevity among various professional groups. Second, they report the results of a pilot survey of 27 master's level oncology social workers in Michigan designed to explore the perceived impact of variables identified in the literature-personal history, patient-related factors, organizational dynamics, social support, and burnout on survival in professional practice. Third, the authors describe a survey instrument they developed to investigate the impact of these variables in more depth with a larger population of oncology social workers. The survey was distributed to 571 members of the National Association of Oncology Social Workers in the spring of 1991, and the data is currently being analyzed. Finally, the authors briefly discuss the implications that the results of the larger study may have for selecling, supervising, and training oncology social workers and other professionals in ...

Development of a Parent Advocate Program as Part of a Pediatric Hematology/Oncology Service

Abstract: The provision of peer support by individuals who have had personal experience with a particular crisis can be a vital component in facilitating the adjustment process of others who are confronted with the sane crisis. There is growing interest in using such peer support for thc parents of children and adolescents with diseases such as cancer. This article describes the historical development and current focus of the Parent Advocate Program within the Division of Pediatric Hematology Oncology at the University of Rochester Medical Center, Rochester, New York. The authors discuss potential pitfalls, such as emotional involvement with families on the parent advocate's part, and present ingredients for the development of a successful program, including careful selection of individuals who can interact successfully with various staff members and learn the professional role of parent advocate.

Addressing the Needs of Survivors

Abstract: Addressing the needs of cancer survivors is an emerging challenge for the coming decade. Numerous studies indicate that survivors may be struggling with a variety of problems. A number of interventions are available to help survivors, but it is difficult, time consuming, and expensive for clinicians and administrators to determine which intervention will be acceptable and affordable. The authors propose an Action Research approach involving critical decision makers in a cyclic process of fact finding, planning, action, and evaluation in which the fact-finding process serves as a basis for structuring subsequent objectives and actions and for using research results for planning as well as theory development. In addition, they provide a framework for the approach and suggest strategies for involving not only administrators and members of the medical team but also survivors themselves in developing effective programs and overcoming potential service barriers.

Relationships Between Emotional Distress and Psychosocial Concerns Among Newly Diagnosed Cancer Patients

Abstract: Forty-four newly diagnosed oncology outpatients completed self-report forms that assessed their mood state and types and levels of psychosocial concerns at three points (at entry and three and six months later) during their initial six months of treatment. The levels of their psychosocial concerns were further assessed by auditing their medical records. The data analysis focused on how these measures of psychosocial concerns were related to stage of cancer, type of treatment, and levels of mood disturbance and psychosocial concerns. Stage of disease did not correlate with the levels and types of psychosocial concerns, whereas treatment modality and mood disturbance did. The results indicated that specific screening and inquiry into types of concerns and emotional distress, including distinctions between somatic and nonsomalic concerns, rather than reliance on routine interactions during physical examinations or treatments, should be considered when evaluating patients' psychosocial concerns and emotional ...

The Partnership of Empowerment

Abstract: Life is a hollow gift unless cancer survivors emerge from treatment as competent and worthy individuals, able to obtain insurance, equipped to earn a living, and prepared to participate in a medical surveillance program to "keep" the life they have won. The author describes the obstacles involving schooling, military service, employment, and insurance hat hinder a full life after cure and suggests strategies for supporting a partnership consisting of the medical team, the patient and family, and peer organizations to overcome these obstacles.

Remembrance Programs at Camps for Children with Cancer

Abstract: Camps for children with cancer have become increasingly popular over the last decade. As camps increase in longevity, addressing the death of former campers will become an important concern. To understand varying opinions on this topic better, the authors interviewed camp directors, camp counselors, campers, and parents about holding remembrance programs for deceased campers at a camp. The majority of campers and parents and the counselors who either had had cancer or had a sibling with cancer were in favor of holding remembrance programs at camp. In addition, they were in substantial agreement that older children should be involved in the decision whether to hold a remembrance program. Counselors who had no personal experience with cancer were uncertain about the beneficial effects of a remembrance program. The authors discuss the results in terms of the need to educate staff about the psychological and ethical aspects of including children in decision making and the need for camps to review the goals of...

Cancer and addictions: The potential for family and staff collusion

Abstract: Although often sensationalized in the media, addictive behaviors and co-dependency cause painful dilemmas for millions of Americans. Unfortunately, many people with these disorders also are diagnosed with cancer or have a family member with cancer. Addiction and the problematic coping style associated with it are rarely addressed by oncology staff. However, data collected through the Johns Hopkins Cancer Counseling Center indicate that 21 of 36 patients referred for long-term counseling were addicts and that 15 were co-dependent. The authors address the problem of identifying patients and families with these disorders and describe appropriate methods of helping them cope with the added distress caused by the diagnosis of cancer.