Group support for patients with metastatic cancer. A randomized outcome study.
01 May 1981-Archives of General Psychiatry (American Medical Association)-Vol. 38, Iss: 5, pp 527-533
TL;DR: Objective evidence is provided that a supportive group intervention for patients with metastatic cancer results in psychological benefit and mechanisms underlying the effectiveness of this group intervention are explored.
Abstract: • The effects of weekly supportive group meetings for women with metastatic carcinoma of the breast were systematically evaluated in a one-year, randomized, prospective outcome study. The groups focused on the problems of terminal illness, including improving relationships with family, friends, and physicians and living as fully as possible in the face of death. We hypothesized that this intervention would lead to improved mood, coping strategies, and self-esteem among those in the treatment group. Eighty-six patients were tested at four-month intervals. The treatment group had significantly lower mooddisturbance scores on the Profile of Mood States scale, had fewer maladaptive coping responses, and were less phobic than the control group. This study provides objective evidence that a supportive group intervention for patients with metastatic cancer results in psychological benefit. Mechanisms underlying the effectiveness of this group intervention are explored.
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01 Jan 2004
TL;DR: Life and death, emotion and social support, stress and disease are universal human concerns, but the experience of cancer and its treatment is inevitably influenced by cultural, ethnic, economic, and religious differences.
Abstract: Life and death, emotion and social support, stress and disease are universal human concerns. The diagnosis of cancer induces a human dread that is grounded in our biological being. Nonetheless, the experience of cancer and its treatment is inevitably influenced by cultural, ethnic, economic, and religious differences. In some cultures, the diagnosis of cancer conveys a greater sense of shame than others. Only recently have Japanese cancer patients been willing to make public declarations of their disease status, forming heretofore unheard of support groups such as “Akai Bono Kai.” Cultural concerns about modesty and sexuality, or cultural acceptance of a fatalistic approach to life may inhibit screening activities in certain cultures, such as among Chinese and Latina women. Direct talk about the future that might make an American cancer patient feel respected and involved in treatment could seem to a Chinese cancer patient a self-fulfilling prophesy of doom. De Toqueville described Americans as a “nation of joiners.” We tend to be relatively direct and open, inclined to discuss problems and try to solve them. At the same time, we do not like to admit to having problems, and often lose ourselves in work and other activities when confronted with threats to health. Our desire for openness and shared decision-making in medical care is not entirely consistent with our belief in success, in
15 citations
TL;DR: Two feasibility studies were conducted to assess patient willingness to receive outcall telephone counseling and their willingness to share sensitive psychosocial concerns over the telephone, and suggest that telephone outcalls are feasible for both breast and prostate cancer patients.
Abstract: Telephone counseling of cancer patients has existed on a limited basis for a number of years. One aspect of telephone counseling that has not been adequately explored involves using an outcall strategy, in which the counseling service would call the patient according to a prearranged schedule. Such a strategy could be used to overcome the potentially significant barrier of requiring the patient to proactively call the counseling service. As a preliminary phase in the development of a larger program of research on telephone counseling of cancer patients, two feasibility studies were conducted to assess patient willingness to receive outcall telephone counseling and their willingness to share sensitive psychosocial concerns over the telephone. The results obtained from both feasibility studies suggest that telephone outcalls are feasible for both breast and prostate cancer patients. Additional research is proposed to test the efficacy of psychosocial counseling by telephone using an outcall format.
15 citations
TL;DR: Research evidence on the management of primary breast cancer is described, defined as tumours of less than 5 cm diameter with no evidence of distant spread or metastases, based on analysis carried out for cancer guidance published by the United Kingdom Department of Health.
Abstract: This paper describes research evidence on the management of primary breast cancer, defined as tumours of less than 5 cm diameter with no evidence of distant spread or metastases. It is based on Effective Health Care, Vol 2, No 6, which summarises analyses carried out for cancer guidance published by the United Kingdom Department of Health.' 2The aim of the guidance was to identify characteristics of care which are associated with improved outcomes for patients.
14 citations
TL;DR: A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease: The Alzheimer's Disease Cooperative Study.
Abstract: (1998). Getting There Is Half the Fun: Relating Happiness to Health. Psychological Inquiry: Vol. 9, No. 1, pp. 66-68.
14 citations
01 Apr 2005
TL;DR: The clinical characteristics of normal grief and clinical depression are reviewed and strategies for differential diagnosis are explained, including extrapolations from existing literature and expert opinion.
Abstract: Psychological distress often causes suffering in terminally ill patients and their families and poses challenges in diagnosis and treatment. Increased attention to diagnosis and treatment of depression can improve the coping mechanisms of patients and families. This paper reviews the clinical characteristics of normal grief and clinical depression and explains strategies for differential diagnosis. Although some literature discusses the psychological issues facing elderly patients and terminally ill patients with cancer, less is known about patients with end-stage pulmonary, cardiac, renal, and neurologic disease. Data on the effectiveness of interventions in terminally ill patients are lacking. Treatment recommendations in this paper represent extrapolations from existing literature and expert opinion. Diagnosing and treating depression in terminally ill patients involve unique challenges. Evidence of hopelessness, helplessness, worthlessness, guilt, and suicidal ideation are better indicators of depress...
14 citations
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TL;DR: In this paper, the effects of reward or reinforcement on preceding behavior depend in part on whether the person perceives the reward as contingent on his own behavior or independent of it, and individuals may also differ in generalized expectancies for internal versus external control of reinforcement.
Abstract: The effects of reward or reinforcement on preceding behavior depend in part on whether the person perceives the reward as contingent on his own behavior or independent of it. Acquisition and performance differ in situations perceived as determined by skill versus chance. Persons may also differ in generalized expectancies for internal versus external control of reinforcement. This report summarizes several experiments which define group differences in behavior when Ss perceive reinforcement as contingent on their behavior versus chance or experimenter control. The report also describes the development of tests of individual differences in a generalized belief in internal-external control and provides reliability, discriminant validity and normative data for 1 test, along with a description of the results of several studies of construct validity.
21,451 citations
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01 Jan 1969
TL;DR: In this article, the implications of terminal illness for patients and for those involved in their care were discussed, and patients invited to talk about their experience found great relief in expressing their fear and anger and were able to move towards a state of acceptance and peace.
Abstract: Although most areas of human experience are nowadays discussed freely and openly, the subject of death is still surrounded by conventional attitudes and reticence that offer only fragile comfort because they evade the real issues. The dying may thus be denied the opportunity of sharing their feelings and discussing their needs with family, friends, or hospital staff. Although receiving devoted medical care, a dying patient is often socially isolated and avoided, since professional staff and students can find contact painful and embarrasing.
Aware of the strains imposed on all sides by this situation, Dr Kubler-Ross established a seminar at the University of Chicago to consider the implications of terminal illness for patients and for those involved in their care. Patients invited to talk about their experience often found great relief in expressing their fear and anger and were able to move towards a state of acceptance and peace. The seminar, initially composed of students of medicine, sociology, psychology, and theology, but later joined by hospital staff and relatives of patients, enabled many members to come to terms with their own feelings and to respond constructi to what the patients had to teach them.
5,220 citations
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1,254 citations
TL;DR: A study of 800 outpatient visits to Children's Hospital of Los Angeles as discussed by the authors explored the effect of verbal interaction between doctor and patient on patient satisfaction and follow-through on follow-up.
Abstract: Study of 800 outpatient visits to Childrens Hospital of Los Angeles to explore the effect of the verbal interaction between doctor and patient on patient satisfaction and follow-through on...
947 citations