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: A review of the inclusion of minorities and non-traditional, non-middle-class groups shows that they are not adequately represented in current intervention research in psychosocial oncology.
Abstract: Today only half of those diagnosed with cancer will die of the disease, leaving enormous room for psychosocial interventions to improve the psychological or functional status of those coping with the disease. Therefore, social workers in oncology must be current with empirical research. In an effort to integrate current research into social work practice, we reviewed empirical studies with sound research designs to answer the following questions: (1) What portion of cancer patients are likely to need social work services? (2) What types of services do social workers provide to meet these needs? and (3) Who is likely to be (or not to be) the recipient of these services. Does intervention research include diverse (non-traditional, non-white and non-middle class) clients? The results show about one third of patients will be judged at high-risk for psychosocial problems but that only 15-25% of those who are diagnosed with cancer will eventually use psychosocial oncology services. Some have mainly instrumental, concrete needs, and others will use psychosocial counseling. A review of the inclusion of minorities and non-traditional, non-middle-class groups, shows that they are not adequately represented in current intervention research in psychosocial oncology. Methods for enlarging their access and participation are suggested.
28 citations
TL;DR: The role of psychological factors in disease promotion and progression, the impact of neoplastic disease and its treatment on psychosocial functioning, and the long‐term impact of cancer and cancer treatment on the survivor and issues of family bereavement following the death of a cancer patient are outlined.
Abstract: This article outlines current issues in the study of psychological factors and cancer: (1) the role of psychological factors in disease promotion and progression, (2) the impact of neoplastic disease and its treatment on psychosocial functioning, and (3) the long-term impact of cancer and cancer treatment on the survivor and issues of family bereavement following the death of a cancer patient. The discussion ends with a consideration of future directions for research.
28 citations
TL;DR: This pilot trial suggests a focused narrative intervention in palliative care patients with moderate to severe depression can reduce depression scores more than usual care alone, and the need for a fully powered trial is supported.
Abstract: Background:Depression is poorly detected and sub-optimally managed in palliative care patients, and few trials of psychosocial interventions have been carried out in this group of patients.Aims:A pilot trial to determine the effect of a focused narrative intervention on depression in palliative care patients when used in addition to usual care.Design:Patients scoring 10 or higher on Patient Health Questionnaire-9 randomised to focused narrative intervention in addition to usual care or usual care only and followed up at 2, 4 and 6 weeks. A reduction of five points on Patient Health Questionnaire-9 was regarded as clinically significant response to treatment.Setting/participants:Palliative care patients aged over 18 recruited from hospice day care services – exclusion criteria included an estimated prognosis of 6 weeks or less, cognitive impairment and unable to understand written or spoken English.Results:Out of 57 participating patients (71% female), with mean age 65.1 years (range 36–88 years), 33 patie...
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TL;DR: The usefulness of Existential Psychotherapy in hypnotic interventions for mediating somatic and psychosomatic symptomatology is addressed.
Abstract: Existential Psychological Theory was employed as a conceptual and theoretical foundation for the use of hypnotically facilitated therapy in the management of intractable pain, nausea, and vomiting in 3 end-stage, terminally ill cancer patients. The existential principles of death anxiety, existential isolation, and existential meaninglessness were addressed with a combination of classic and Ericksonian techniques. The intractable nature of the presenting physical symptoms was conceptualized as a possible manifestation of the impact of the terminal prognosis. Direct hypnotic suggestions for the management of pain, nausea and vomiting were avoided. It was hypothesized that, as the existential conflicts associated with the patients' terminal status resolved, the physiological symptoms would become responsive to medication. After 6 sessions grounded in the principles of Existential Psychotherapy, the intractable status of the physical symptomatology remitted, and the patients responded to medical management. This paper addresses the usefulness of Existential Psychotherapy in hypnotic interventions for mediating somatic and psychosomatic symptomatology.
27 citations
Cites background from "Group support for patients with met..."
...Spiegel, Bloom, and Yalom (1981) provided empirical evidence supportive of Feifel 's (1977) prognostications regarding the benefits of meeting the emotional needs of the terminally ill....
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TL;DR: Results indicate that even if women-only HIV support groups do not stress behavior or lifestyle changes, these are often by-products of support group attendance.
Abstract: Women living with HIV often feel isolated. One significant avenue for HIV-positive women to receive the support, information, and affiliation they need is through gender-specific HIV support groups, but research is lacking about how support groups for HIV-positive women can be helpful. This exploratory study examined HIV-positive women's perceptions about their experiences in women-only HIV support groups. Seventy-one women attending nine women-only HIV support groups in Alabama, Georgia, and South Carolina were surveyed. Benefits from attendance included: (a) increase in medication compliance, (b) decreased risk behavior for re-exposure to HIV, (c) reduced feelings of shame, and (d) a network of friends to socialize with. Results indicate that even if women-only HIV support groups do not stress behavior or lifestyle changes, these are often by-products of support group attendance.
27 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