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: Risk factors for adverse late effects that contribute to morbidity and mortality in cancer survivors are examined, a literature review on interventions to modify these risks factors is provided, and the national recommendations and associated current practices for identifying and managing these risk factors are summarized.
Abstract: Cancer survivors face significant morbidity and mortality associated with their disease and treatment regimens, some of which can be improved through modifying behavioral and psychosocial risk factors. This article examines risk factors for adverse late effects that contribute to morbidity and mortality in cancer survivors, provides a literature review on interventions to modify these risks factors, and summarizes the national recommendations and associated current practices for identifying and managing these risk factors. Finally, future directions for research and clinical practice are discussed. Cancer Epidemiol Biomarkers Prev; 20(10); 2068–77. ©2011 AACR .
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TL;DR: One of the most important issues in providing supportive care to cancer patients in the future is to meet the individual needs of patients and provide the type of psychological therapy that will work best for them.
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TL;DR: The mixed findings may indicate that social support has only small effects on emotional functioning and stress reactions, but the results on the second assessment indicate, however, that socialSupport might work as a buffer against reactions toward external stressful events such as terminal cancer.
Abstract: Objective: To examine the relationship between social support and emotional functioning and stress reactions. Our hypothesis is that patients who reported a high degree of social support will experience better emotional functioning and less serious stress reactions than patients with a low degree of social support.Method: The sample was comprised of 434 patients at the Palliative Medicine Unit (PMU), University Hospital of Trondheim in Norway. The patients completed a questionnaire monthly including questions about social support from the MacAdam's Scale, subjective stress measured by the Impact of Event Scale (IES), and emotional functioning measured by the subscale in the EORTC QLQ-30.Results: Although our hypothesis was not supported at the baseline assessment, it was supported at the second assessment, 2 months later. Patients with high social support reported better emotional functioning and less serious stress reactions, in terms of lower scores on the IES avoidance subscale, than patients with a low degree of social support.Significance of the results: The mixed findings may indicate that social support has only small effects on emotional functioning and stress reactions. Our results on the second assessment indicate, however, that social support might work as a buffer against reactions toward external stressful events such as terminal cancer.
50 citations
Cites background from "Group support for patients with met..."
...Although there is some research on the effects of support groups on cancer victims’ adjustment to the disease and their changed life situation ~Spiegel et al., 1981, 1989; Greer et al., 1992; Spiegel, 1994; Fawzy et al., 1996; Spiegel & Kato, 1996; Fawzy & Fawzy, 1998; Koopman et al., 1998; Goodwin…...
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...…who participated in such a group had a better psychosocial adjustment to the disease compared to those in a control group without such support ~Spiegel et al., 1981, 1989; Greer et al., 1992; Spiegel, 1994; Fawzy et al., 1996; Spiegel & Kato, 1996; Fawzy & Fawzy, 1998; Koopman et al., 1998;…...
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TL;DR: There is a lack of well-designed clinical trials to evaluate pharmacologic agents for the treatment of cancer-related fatigue, and an individualized treatment plan that includes several modalities may be developed.
Abstract: Fatigue, a common complaint of cancer patients, requires a multidisciplinary evaluation and treatment approach because of the multiple etiologies and contributing factors. Current treatments for fatigue include educating patients and caregivers about fatigue, applying etiology-specific treatments, utilizing nonpharmacologic interventions, and prescribing pharmacologic therapies. Often, an individualized treatment plan that includes several modalities may be developed. Presently, there is a lack of well-designed clinical trials to evaluate pharmacologic agents for the treatment of cancer-related fatigue.
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TL;DR: As the use of tamoxifen increases, it will be essential to consider the potential side effect of depression, which in itself may alter immune function and overall survival.
Abstract: Tamoxifen is widely used for the treatment of breast cancer. While it is generally well tolerated, clinically relevant depression may be a common side effect. This article reviews reports of depression associated with tamoxifen and considers the specific qualities of tamoxifen that may account for depressive symptomatology. A multitude of factors may be responsible for depression in the breast cancer patient such as adjuvant therapy, stage of treatment, and poor body image. Tamoxifen distinguishes itself due to its potential activity at the neuroendocrine level. Antagonist qualities of tamoxifen may block the neuroprotective effects of estrogen. This may result in down-regulation of neurotransmitters associated with mood regulation such as serotonin and norepinephrine. Additional research into the mechanism of tamoxifen-associated depression is needed. As the use of tamoxifen increases, it will be essential to consider the potential side effect of depression, which in itself may alter immune function and overall survival. The risk and benefits of tamoxifen must be carefully weighed and depressive symptoms should be monitored and treated in women receiving tamoxifen therapy.
50 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
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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