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 2003
TL;DR: In this paper, the authors evaluated the effect of a standardized group psychosocial intervention on health-related quality of life (HrQOL) in women with metastatic breast cancer.
Abstract: Purpose: To evaluate the effect of a standardized group psychosocial intervention on health-related quality of life (HrQOL) in women with metastatic breast cancer and to explore the effect of missing data in HrQOL analyses. Patients and Methods: Between 1993 and 1998, seven Canadian centers randomly assigned 235 eligible women to participate in a weekly, 90-minute, therapist-led support group that adhered to principles of supportive-expressive (SE) therapy or to a control arm (no SE). All women received educational material and any type of medical or psychosocial care deemed necessary. HrQOL data were prospectively collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) at baseline, 4, 8, and 12 months. The primary HrQOL analyses compared scores in the two study arms. Analyses were limited to women with appropriate baseline HrQOL information (n 215). Results: Baseline EORTC QLQ-C30 scores were not different between the two study arms (all P > .05). Primary analysis of all subscales failed to show a significant influence of the intervention on HrQOL (all P > .05). There was a significant deterioration over time in several functional scales of the EORTC QLQ-C30: global (P .03), physical (P .0002), role (P .01), and cognitive functioning (P .04); and in symptom scales: dyspnea (P .007), appetite loss (P .04), and fatigue (P .003); these changes were independent of randomization allocation. Results were similar in additional analyses of overall HrQOL using a variety of approaches to handling missing data. Conclusion: Supportive-expressive group therapy in patients with metastatic breast cancer does not appear to influence HrQOL, as measured by the EORTC QLQ-C30. J Clin Oncol 21:1944-1951. © 2003 by American Society of Clinical Oncology.
01 Jan 2022
TL;DR: A review of the history of psycho-oncology, unique concerns arising from adaptation to cancer diagnosis, and assessment and management of major psychiatric disorders in cancer can be found in this paper .
Abstract: Psycho-oncology, the study and treatment of the psychological and psychiatric aspects of cancer, addresses the psychological response to cancer of patients, their families, and their care providers. Clinicians and researchers from psychiatry, psychology, social work, nursing, and clergy offer unique tools to alleviate distress as members of diverse interdisciplinary psycho-oncology teams. Psychotherapeutic modalities developed for cancer patients and communication skills training empower providers to manage the complex needs of cancer patients with evidence-based interventions. This chapter reviews the history of psycho-oncology, unique concerns arising from adaptation to cancer diagnosis, and assessment and management of major psychiatric disorders in cancer. Psychosocial care of families, bereavement, and cancer survivorship are also discussed.
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01 Jan 1987
TL;DR: Rationale is discussed under the following headings: principles of pain control; causes of pain; and analgesic modalities and factors impinging on their efficacy.
Abstract: Pain control is recognised as perhaps the most important single objective in the patient with terminal disease. Cancer, cardiovascular disease and obstruc tive airways disease are foremost among many causes of pain requiring control in the terminal phase. Spiritual, emotional, religious and socio-economic factors are important in raising or lowering the pain threshold. Analgesic strategies include use of drugs, neuro surgery, radiotherapy and supportive measures which may be brought to bear singly or in combination as required. Pain is clinically classified as being acute or chronic, by the type of patient, and by a series of common pain syndromes and their pathological . mechanisms. General concepts of control of pain and discomfort in disease are' discussed, together with a brief comment on epidemiology, in the first part of the article. Rationale is then discussed under the follow ing headings: (I) principles of pain control; (i/) causes of pain; and (iil) analgesic modalities and factors impinging on their efficacy.
02 May 2005
TL;DR: Evidence on the impact of psychological interventions on survival in patients suffering from one of two leading causes of death in developed countries: coronary heart disease and cancer is reviewed.
Abstract: This paper reviews evidence on the impact of psychological interventions on survival in patients suffering from one of two leading causes of death in developed countries: coronary heart disease and cancer. “Psychological interventions” in this context refers to those procedures commonly thought of as psychotherapy. Studies employing randomized controlled trials (RCTs) are considered. While there are inconsistencies in the literature, there is promising evidence on the potential for psychotherapy to affect survival from these two diseases. Beneficial effects on survival have been documented in about half of the controlled trials that have been reported in the literature. Limitations of these findings are considered and promising directions for future research identified.
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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.
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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