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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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Journal ArticleDOI
TL;DR: Improvements in mood reported by 53 cancer patients of varying diagnoses who were randomized into two brief, group programs were compared: a psychoeducational or coping skills training program, which included some supportive discussion; and a control intervention comprising supportive discussion alone.

133 citations

Journal ArticleDOI
TL;DR: Reviewing the evidence on the efficacy of different types of existential therapies found particular support for structured interventions incorporating psychoeducation, exercises, and discussing meaning in life directly and positively with physically ill patients.
Abstract: OBJECTIVE To review the evidence on the efficacy of different types of existential therapies: a family of psychological interventions that draw on themes from existential philosophy to help clients address such issues in their lives as meaning and death anxiety. METHOD Relevant electronic databases, journals, and reference lists were searched for eligible studies. Effects on meaning, psychopathology (anxiety and depression), self-efficacy, and physical well-being were extracted from each publication or obtained directly from its authors. All types of existential therapy for adult samples were included. Weighted pooled mean effects were calculated and analyses performed assuming fixed-effects model. RESULTS Twenty-one eligible randomized controlled trials of existential therapy were found, from which 15 studies with unique data were included, comprising a total of 1,792 participants. Meaning therapies (n = 6 studies) showed large effects on positive meaning in life immediately postintervention (d = 0.65) and at follow-up (d = 0.57), and had moderate effects on psychopathology (d = 0.47) and self-efficacy (d = 0.48) at postintervention; they did not have significant effects on self-reported physical well-being (n = 1 study). Supportive-expressive therapy (n = 5) had small effects at posttreatment and follow-up on psychopathology (d = 0.20, 0.18, respectively); effects on self-efficacy and self-reported physical well-being were not significant (n = 1 and n = 4, respectively). Experiential-existential (n = 2) and cognitive-existential therapies (n = 1) had no significant effects. CONCLUSION Despite the small number and low quality of studies, some existential therapies appear beneficial for certain populations. We found particular support for structured interventions incorporating psychoeducation, exercises, and discussing meaning in life directly and positively with physically ill patients. It is important to study more precisely which existential intervention works the best for which individual client.

133 citations


Cites background from "Group support for patients with met..."

  • ...…attributed to the relatively low quality of the aticles mainly caused by unclear reporting (Spiegel et al., 1981, 1983; Van der Pompe et al., 1997; Weiss et al., 2003), selective reporting (Classen et al., 2008; Spiegel et al., 1981, 1983), and incomplete reporting (Spiegel et al., 1981, 1983)....

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  • ...…interventions could be partially attributed to the relatively low quality of the aticles mainly caused by unclear reporting (Spiegel et al., 1981, 1983; Van der Pompe et al., 1997; Weiss et al., 2003), selective reporting (Classen et al., 2008; Spiegel et al., 1981, 1983),…...

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  • ...…in multiple articles, were about supportive-expressive group therapies (Bordeleau et al., 2003; Classen et al., 2001, 2008; Goodwin et al., 2001; Spiegel et al., 1981, 1989; Spiegel & Glafkides, 1983; Weiss et al., 2003), which are manualized unstructured group interventions for patients…...

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Journal ArticleDOI
TL;DR: Patients who received the intervention had significantly less depression between baseline and the midway point, as well as less anxiety and greater improvement in the role-emotional and mental health subscales of the Medical Outcomes Study 36 Short Form.
Abstract: Purpose/objectives To test the effects of a computer-based nursing intervention designed to provide patients and family caregivers with concrete, objective information on symptom management; provide education about disease and treatment; coordinate medical resources; and provide emotional support and counseling. Design Two-site, randomized clinical trial. Settings A large, urban, midwestern, tertiary-cancer center and a community-based cancer center in a medium-sized midwestern city. Sample 109 patients newly diagnosed with breast, colon, or lung cancer who were receiving chemotherapy; 54 received standard care, and 55 participated in the intervention group. Methods Outcome data were collected via structured telephone interviews at three time points: baseline, midway through the intervention, and one month postintervention. The intervention consisting of nine visits, five in person and four by telephone, was conducted over 18 weeks by advanced practice oncology nurses. Main research variables Psychosocial functioning, anxiety, and depression. Findings Patients who received the intervention had significantly less depression between baseline and the midway point, as well as less anxiety and greater improvement in the role-emotional and mental health subscales of the Medical Outcomes Study 36 Short Form. Conclusions Cancer-care nursing interventions can decrease psychosocial morbidity and improve quality of life for newly diagnosed patients with cancer undergoing treatment. Additional research is needed to understand who benefited most from the intervention. Implications for nursing This nurse-directed intervention resulted in improved mental health for patients; however, physical subscales were not changed. Further work is needed to determine why depression and mental health were affected yet physical health and symptoms did not differ between groups. Results support the important role of nurses in addressing mental health issues in patients and families experiencing cancer.

130 citations


Cites background from "Group support for patients with met..."

  • ...Fawzy et al. (1990), Fawzy and Fawzy (1994), and Spiegel, Bloom, and Yalom (1981) suggested that people with high levels of resourcefulness engage in trial-and-error learning that can result in effective self-management that is totally independent of support programs and interventions....

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Journal ArticleDOI
TL;DR: A brief group intervention can significantly reduce overall distress and accelerate grief reduction in a sample of bereaved subjects unselected for psychopathology or at high risk for subsequent maladjustment.
Abstract: Background Bereavement is a severe and frequent stressor among those infected with human immunodeficiency virus type 1 (HIV-1) and those affected by the acquired immunodeficiency syndrome epidemic. This study examined the impact of a research-derived, semistructured, bereavement support group among HIV-1–seropositive and HIV-1–seronegative homosexual men having lost a close friend or intimate partner to the acquired immunodeficiency syndrome within the prior 6 months. Methods A total of 166 subjects (97 HIV-1 seropositive; 69 HIV-1 seronegative) were randomly assigned to groups of homogeneous HIV-1 serostatus or to their respective control group. Subjects were assessed at entry and at 10 weeks with psychosocial questionnaires, a semistructured interview for psychopathology, a medical history and physical examination, urine collection, and phlebotomy. Results For a composite score of psychological distress and grief as well as the distress component, scores were significantly lower after the intervention by analyses against baseline scores, with and without control variables for other factors affecting distress level. A significant reduction in grief level was found only in the analysis that included control variables. Control subjects showed no significant decrements in overall distress, although a significant decrement in grief level was observed. Conclusion A brief group intervention can significantly reduce overall distress and accelerate grief reduction in a sample of bereaved subjects unselected for psychopathology or at high risk for subsequent maladjustment.

130 citations

Journal ArticleDOI
TL;DR: The psychotherapy and cancer survival debate generated great interest in the psychoneuroimmunological and bio‐behavioral mechanisms that might mediate any gain in survival.
Abstract: The psychotherapy and cancer survival debate generated great interest in the psychoneuroimmunological and bio-behavioral mechanisms that might mediate any gain in survival. Recent methodologically-improved cognitive-existential, supportive-expressive and psycho-educational group interventions for patients with breast cancer and melanoma have not extended survival times. Shorter survival has been associated with social disparity and untreated clinical depression, potentially mediated by poorer adherence to anti-cancer treatments. Group therapy both prevents and treats depression. Future research could address these bio-behavioral mechanisms.

128 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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