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
More filters
TL;DR: This article provides a foundation for integrating neuroendocrine-immune interactions into the formulation of neuropsychiatric and immunologic disease.
167 citations
TL;DR: An intervention to increase coping and decrease distress in persons living with HIV is described and preliminary data from a randomized clinical trial that is being conducted to evaluate the training’s impact on HIV-related distress are reported on.
Abstract: The estimated 12 million people worldwide who are infected with HIV face a chronic and debilitating disease that can create profound psychological distress. Each individual living with HIV confronts uncertainties about their future personal health and prognosis. In the developed world, advances in medical management and treatment of HIV have altered the trajectory of this disease to one of longterm illness. As a result, many individuals with HIV disease live more than a decade with the threat of increasing disability, loss of employment, and premature death. Many HIV-infected persons cope effectively with their condition and continue to lead productive, meaningful lives. Unfortunately, others have dif® culty managing the stresses associated with their condition. The Of® ce of AIDS Research and the National Institute of Mental Health (NIMH), both at the National Institutes of Health, have called for research on interventions to assist HIV-infected individuals to cope with the distress that often accompanies HIV disease and that can interfere with quality of life and adherence to care. While the majority of behavioural research and interventions in the area of HIV/AIDS have focused on the primary prevention of HIV transmission, a number of investigators have been conducting research designed to develop and evaluate interventions to increase coping and decrease distress in persons living with HIV1± 5. This paper describes one such intervention, Coping Effectiveness Training6,7, and reports on preliminary data from a randomized clinical trial that is being conducted to evaluate the training’s impact on HIV-related distress. In the face of the worldwide epidemic, some might argue that interventions are a luxury that we cannot afford. We believe that there are a number of compelling reasons to help those who are infected. First and foremost, there is the humanitarian imperative. If we have the capacity to deliver treatments that can ease pain and suffering and provide support, we have a responsibility to make these available. Second, assisting HIV-infected persons to cope with their disease will reduce distress, which is associated with non-adherence to care. Thus, coping interventions may increase adherence and reduce health care costs associated with HIV. Third, to the extent that distress has been associated with high-risk sexual behaviour8, assisting HIV-infected persons to cope with distress may reduce high-risk behaviour and reduce the likelihood of HIV transmission.
165 citations
TL;DR: There is a relationship between pain and mood in oncology outpatients and that health-care professionals need to assess for mood disturbances in this population and develop appropriate treatment strategies.
161 citations
TL;DR: It is concluded that many of the psychological changes made by subjects in longer term interventions may elude conventional psychometric assessment and a clearer understanding of the experience of living and eventually dying of cancer within the context of a long term intervention is required.
Abstract: Research has demonstrated that short term psychological interventions improve the quality of life of cancer patients. However, there is much less evidence for the efficacy of longer term interventions. We report the psychometric results from a randomized clinical trial (n=66) assessing the effects of an 8 month, weekly psychological intervention on 30 metastatic breast cancer patients. Subjects were assessed at baseline, 4, 8 and 14 months for mood, quality of life and adjustment to cancer. Results demonstrated little psychometric difference between the control (n=36) and intervention groups over this length of time, in spite of the fact that when the intervention subjects attended a weekend of support and training in coping skills, the usual significant, short term changes were observed. In the long term intervention, subjects did experience more anxious preoccupation and less helplessness than the controls but no recorded improvements in mood or quality of life. However, profound clinical changes were observed by the therapists, similar to those noted by Spiegel et al. (1981). We conclude that many of the psychological changes made by subjects in longer term interventions may elude conventional psychometric assessment. Further research, of a rigorous qualitative nature, is required to develop a clearer understanding of the experience of living and eventually dying of cancer within the context of a long term intervention. Copyright © 1999 John Wiley & Sons, Ltd.
160 citations
TL;DR: An emerging literature demonstrates that fear of cancer recurrence (FCR) is a problematic long‐term and late effect for cancer survivors, and this article provides a necessary synthesis of the extant research evidence and theory.
Abstract: Background
There is increasing recognition of the unique physical and psychosocial concerns of the growing population of cancer survivors. An emerging literature demonstrates that fear of cancer recurrence (FCR) is a problematic long-term and late effect for cancer survivors. In fact, FCR is a top concern, and this article provides a necessary synthesis of the extant research evidence and theory.
Methods
Literature searches were conducted using databases including MEDLINE and PsychINFO using specified search terms including ‘fear of recurrence’ and ‘worry about recurrence’. A comprehensive narrative review summarizes early empirical findings on FCR including current definitions, assessment tools, clinical presentations, quality of life impact, prevalence, trajectory and risk factors. This paper also critically reviews the relevant theoretical frameworks to best understand these findings and considers multiple psychosocial treatment models that may have relevance for addressing FCR in the clinical setting.
Results
There is evidence of substantial prevalence and quality of life impact of FCR. Several theories (e.g. self-regulation model of illness, a family-based model, uncertainty in illness theory, social-cognitive processing theory, terror management theory) directly or indirectly help conceptualize FCR and inform potential treatment options for those with clinically significant distress or impairment resulting from FCR.
Conclusions
Further investigation into FCR is warranted to promote evidence-based care for this significant cancer survivorship concern.
159 citations
References
More filters
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
3,765 citations
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