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: Both pharmacotherapy and psychotherapy have been found to treat effectively depressive symptoms in women with metastatic breast cancer, but cognitive-behavioral therapy appears to be the most cost-effective approach.
Abstract: Objective:The aim of this article is to review the available literature on depression in women with metastatic breast cancer in terms of prevalence, potential risk factors, and consequences, as well as pharmacological and psychological interventions.Method:An extensive review of the literature was conducted.Results:The prevalence of depression appears to be especially elevated in patients with advanced cancer. Many demographic, medical, and psychosocial factors may increase the risk that women will develop depressive symptoms during the course of their illness. Despite the fact that depression appears to be associated with numerous negative consequences, this disorder remains underdiagnosed and undertreated. Both pharmacotherapy and psychotherapy have been found to treat effectively depressive symptoms in this population, but cognitive-behavioral therapy appears to be the most cost-effective approach.Significance of results:Areas for future research are suggested.
69 citations
Cites background from "Group support for patients with met..."
...Spiegel et al. (1981) conducted a randomized and controlled study among women with metastatic breast cancer in order to evaluate the efficacy of supportive–expressive therapy (n ¼ 34) compared to an untreated control group (n ¼ 24)....
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TL;DR: Cancer cachexia tends to occur in patients with solid tumors, in children, and in elderly patients, and is associated with anorexia (loss of appetite), asthenia and changes in body image.
Abstract: Cachexia may occur in up to 80% of patients with advanced cancer.1 This complex metabolic syndrome, characterized by profound loss of lean body mass, is the main cause of death in 20% of patients. Cachexia (involuntary loss of more than 10% of premorbid weight) is a marker for poor prognosis2 and is associated with anorexia (loss of appetite), asthenia and changes in body image. Cancer cachexia tends to occur in patients with solid tumors, in children, and in elderly patients. Cachexia is also common in acquired immune deficiency syndrome (AIDS), chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF)3–6 and other chronic illnesses, such as dementia, tuberculosis, malaria,7 chronic kidney disease, liver disease,8 and rheumatoid arthritis.
69 citations
TL;DR: A brief, relatively inexpensive, telephone-based psychosocial intervention is an effective method for reducing distress and increasing health-related quality of life in patients awaiting lung transplantation.
68 citations
TL;DR: Changes in self-efficacy over time would be related to changes in disease progression markers (CD4, viral load) in a sample of women with AIDS and increases in cognitive behavioral skills self- efficacy were significantly related to decreases in viral load.
Abstract: The purpose of the present study was to determine whether changes in self-efficacy over time would be related to changes in disease progression markers (CD4, viral load) in a sample of women with AIDS. A self-efficacy measure was developed and two sub-scales emerged via factor analysis of 391 HIV-positive women: AIDS Self-efficacy and Cognitive Behavioral Skills Self-efficacy. Subsequently, the sub-scales and an additional adherence self-efficacy item were given to 56 HIV-positive women who were measured at two time points three months apart. Half of these women were randomly assigned to a CB intervention and half to a low intensity comparison condition. Increases in AIDS Self-efficacy over the three-month period were significantly related to increases in CD4 and decreases in viral load. Similarly, increases in Cognitive Behavioral Skills Self-efficacy were significantly related to decreases in distress over time. Findings were maintained within the intervention group alone. Interestingly, increases in cognitive behavioral skills self-efficacy and increases in the self-efficacy adherence item were also significantly related to decreases in viral load. Implications of the findings and suggestions for future research are discussed.
68 citations
Cites background from "Group support for patients with met..."
...The expressive-supportive therapy (EST) component of the intervention (Spiegel et al., 1981) was designed to address participant needs for: (1) mutual support and reduced isolation, (2) improved family and social support, (3) greater openness and emotional expressiveness, (4) integration of changed…...
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...…social support) or active-cognitive (finding meaning in an illness, reframing) are associated with more positive affect and higher self-esteem in various populations dealing with chronic illness (Billings & Moos, 1981; Hynes & Werbin, 1977; Spiegel et al., 1981; Yalom & Greaves, 1977)....
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TL;DR: Patient resources for coping with breast cancer can be enhanced by attention to cognitive, affective, psychosomatic, and social components of the illness, as well as the development and pursuit of realistic goals influenced by the prognosis.
Abstract: Patient resources for coping with breast cancer can be enhanced by attention to cognitive, affective, psychosomatic, and social components of the illness. The diagnosis and treatment of breast cancer constitutes an immediate confrontation with mortality, and sympathetic but direct examination of the patient's vulnerability and means of coping with it will reduce rather than amplify death anxiety. The development and pursuit of realistic goals influenced by the prognosis can help patients adjust constructively. Extremes of emotion are to be expected at times, but persistent depression and/or anxiety should be vigorously treated, including the use of appropriate psychoactive medication when the symptoms are primarily somatic (e.g., sleep disturbance and reductions in energy). Physical symptoms such as pain, nausea, and vomiting can be controlled by teaching patients such techniques as self-hypnosis, biofeedback, and systemic desensitization. Finally, a feeling of social isolation is the rule, not the exception, with cancer patients. Group and family treatment can effectively counter this. Systematic studies of such treatment interventions have shown favorable results, including significant reductions in mood disturbance and pain.
68 citations
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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
Book•
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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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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