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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TL;DR: In this article, the authors showed that life skills training is an effective method in reducing symptoms of depression, anxiety, sleep disorders, and somatic disorders in patients with breast cancer.
Abstract: Background: Patients with breast cancer are predisposed to some psychiatric symptoms and mental disorders due to their life styles or disease conditions. These problems cause patients to deal with daily stress, feeling guilty, anxiety, dysphoric mood, and impaired social relations. Such problems would lead to serious mental disorders. Objectives: Therefore, life skills training may help patients to cope better with their condition, and improve their mental health. Materials and Method: In an experimental study, 50 patients with breast cancer were selected randomly and assigned to 2 experimental and control groups. The experimental group attended life skills training classes for 10 weeks continuously (each class lasting 2 hours). Participants in both the experimental and control groups completed a GHQ-28 questionnaire form before the commencement of classes, and again after 2 weeks to 2 months of the course completion. T-test was used as the statistical method. Results: In life skills training group, depressive and anxiety symptoms, somatization disorders, sleep disorders and disorders of social functioning were significantly decreased (p<0.0001). These changes were not observed in the control group. Conclusions: The results showed that life skills training is an effective method in reducing symptoms of depression, anxiety, sleep and somatic disorders. Also, it would be useful in reducing problems of social dysfunction.
11 citations
TL;DR: It is felt that understanding patients' needs for information and communication with physicians and allied health professionals will enrich the caregiver‐patient relationship.
Abstract: A weekly psychotherapy group has been established with 21 diabetic patients (mean sessions attended per patient 12.0 +/- 8.9). In this non-structured group, the topics spontaneously chosen most often for discussion included complications and fears regarding complications, diet, and relationships with physicians. Other topics included difficulties achieving diabetes control, relationships with families, devices for day to day management, pregnancy and parenting, depression and eating disorders, and occupational concerns including driving and diabetes. The presence of a physician co-therapist was found to be valuable. Examples are provided of the patients' concerns. It is felt that understanding patients' needs for information and communication with physicians and allied health professionals will enrich the caregiver-patient relationship.
11 citations
01 Jan 2004
TL;DR: The clinical findings suggested congestive heart failure and malignant disease of the left breast in an 83-year-old woman admitted in August, 2002, who had had left breast oedema and dyspnoea on exertion for 4 weeks.
Abstract: An 83-year-old woman was admitted in August, 2002, having had left breast oedema and dyspnoea on exertion for 4 weeks. She had a history of hypertension. There was no history of injury or infection in the breast. Physical examination showed jugular venous distension and bilateral pretibial pitting oedema. The left breast was enlarged (figure, A) and indurated with diffusely thickened peau d’orange skin. There was no palpable mass, no dimpling of the nipple, and no discharge. The breast was neither inflamed nor tender. The right breast appeared normal. We found no axillary adenopathy. When auscultating the chest, we heard a grade 3/6 holosystolic murmur at the apex and moist rales in bilateral lower lung fields. Chest radiographs showed cardiomegaly with pulmonary congestion. Echocardiography showed mitral insufficiency (grade III/IV) and tricuspid insufficiency (grade I/IV) with left ventricular dysfunction (ejection fraction 31%). The clinical findings suggested congestive heart failure and malignant disease of the left breast. Mammography showed increased opacity, noticeable skin thickening particularly in the periareolar area, and a reticular pattern in the left breast but no evidence of mass or calcification (figure, B). Sonography showed skin thickening with loss of two echogenic skin layers, increased echogenicity in subcutaneous fat, and tubular anechoic structures suggesting dilated lymphatics. We gave her furosemide, spironolactone, ramipril, and digoxin. 2 weeks later, she had lost 5 kg in weight, the signs and symptoms of congestive heart failure had resolved, and the left breast looked normal (figure, D). A second mammography 2 weeks later showed amelioration of the previous abnormalities (figure, C). When last seen in August, 2003, she had no complaints, and the breast looked normal. Unilateral thickening and induration usually suggest inflammatory breast carcinoma. Skin thickening results from oedema and is also seen in lymphatic obstruction of any aetiology. 1-3 In congestive heart failure, bilateral breast oedema with skin thickening can often develop. 1 Oedema in breast carcinoma may be due to congestion or tumour cell infiltration of the dermal and intramammary lymphatics, whereas unilateral breast oedema in congestive heart failure may be caused by a patient’s tendency to lie on one side, leading to dependent oedema. 4 A palpable breast mass is highly suggestive of malignant disease. However, even when oedema is caused by lymphatic invasion, a discrete mass or calcification cannot always be identified. Although pitting oedema of the breast in the absence of a palpable
11 citations
TL;DR: An overview of cancer survivors' experience and satisfaction after taking part in a six-week, cognitive-existential (CE) group intervention that aimed to address FCR is provided.
11 citations
TL;DR: In the absence of a vaccine, prevention represents the major hope for limiting the spread of HIV-1 infection as discussed by the authors. Prevention efforts focus on behavioral change techniques, widespread availability and use of condoms, and substance abuse management and treatment.
Abstract: In the absence of a vaccine, prevention represents the major hope for limiting the spread of HIV-1 infection. Prevention efforts focus on behavioral change techniques, widespread availability and use of condoms, and substance abuse management and treatment. Secondary prevention programs require behavioral interventions to help infected people cope with their illness. Behavioral interventions, such as cognitive behavioral stress management and aerobic exercise, and pharmacologic treatment have begun to improve the management of HIV-1 spectrum disease.
11 citations
References
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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