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Journal ArticleDOI

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.
Citations
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Dissertation
18 Feb 2011
TL;DR: Nurses’ experiences of being with patients facing the threat of mortality and the experience of fighting cancer while preparing for the possibility of letting go were explored, indicating a potential to enhance nurses’ supportive care constituted by their perceived responsibility to engage and respond to patients’ existential distress.
Abstract: Patients are living longer with many types of cancer; however, often they face sudden possibilities of dying, not only due to their advancing illness but due to complications of their treatment. Consequently, they can express substantial existential distress. Nurses’ close proximity to patients puts them in an ideal place to assess and engage with patients’ existential distress; yet this kind of research has been scarce. The purpose of this doctoral thesis was to explore nurses’ experiences of being with patients facing the threat of mortality. Yalom describes this threat as the fear of death, isolation, anxiety and responsibility about freedom, and meaninglessness. The study took place in a cancer setting where care is highly technological and goals of cure dominate, specifically, two bone marrow transplant units of one institution in Canada. Benner’s methodology of interpretive phenomenology guided data collection and analysis of focused observations and interviews with 19 registered nurses. The experience of fighting cancer while preparing for the possibility of letting go was the main theme. Letting go did not reflect nurses’ intents to abandon life but to release patients (if only briefly) from perceived norms of the curative culture. More specifically, the main theme was characterized by: 1) working within the culture of cure and the possibilities of patients dying, 2) concern about “bursting the bubble of hope,” 3) whether to and how to respond to patients’ distress and dying, and 4) coping with patient involvement. In the context of responsive relationships (patients and iii their families, and healthcare colleagues), nurses reported engaging in communication about the threat of patients’ mortality, and responding with letting be and supporting families to let go, the management of technology and prevention of technological intrusions, and striving for patients to have “easier” deaths. Results indicate a potential to enhance nurses’ supportive care constituted by their perceived responsibility to engage and respond to patients’ existential distress. Moreover, this study suggests that more attention is warranted not only to policy, education, and research that focuses on patients’ existential well-being, but to the well-being of nurses working within tensions of curing and comforting.

4 citations

Book ChapterDOI
01 Jan 2020
TL;DR: In this paper, the authors present a case example of spiritually-integrated treatment, clinical approaches to the diagnosis and treatment of symptoms related to existential questioning, and challenges involved in dealing with S/R at the end of life are also discussed.
Abstract: Life-threatening illnesses often raise existential questions that have historically been addressed by spirituality and religion (S/R). It is therefore no surprise that S/R plays a key role in end-of-life (EOL) care, for many individuals. This chapter reviews research regarding the place of S/R in the process of coping with life-threatening illnesses, and EOL care. Using a case example of spiritually-integrated treatment, clinical approaches to the diagnosis and treatment of symptoms related to existential questioning are presented. Ethical, educational and research challenges involved in dealing with S/R at the end of life are also discussed.

4 citations

Journal ArticleDOI
TL;DR: Electronic teaching modules for biobehavioral skill training are feasible and promise to reduce the time need for life interactions with instructors.

4 citations

Journal ArticleDOI
01 Jan 1988
TL;DR: The scope that exists for increasing the personal autonomy of people with cancer is assessed and coping theory suggests that autonomy can be enhanced by complementary therapies, by changing perceptions of cancer, and by techniques which minimize the emotional response to the stress of this disease.
Abstract: This paper assesses the scope that exists for increasing the personal autonomy of people with cancer. Current organization of cancer services does little to promote autonomy. However, coping theory suggests that autonomy can be enhanced by complementary therapies, by changing perceptions of cancer, and by techniques which minimize the emotional response to the stress of this disease.

4 citations

References
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Journal ArticleDOI
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

Book
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

Journal ArticleDOI
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

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