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: To formulate guidelines on the assessment, diagnosis and treatment of depressive symptoms in patients with advanced cancer, based on a review of the literature and clinical experience.
Abstract: OBJECTIVE To formulate guidelines on the assessment, diagnosis and treatment of depressive symptoms in patients with advanced cancer, based on a review of the literature and clinical experience. DATA SOURCES Articles from a range of international, peer-reviewed journals, texts by acknowledged experts and diagnostic manuals. STUDY SELECTION The works cited focused either on the prevalence and diagnosis of depression in patients with cancer or related conditions or on the management or treatment of depressive symptoms arising in these patients. DATA EXTRACTION Information was summarised and integrated into the management strategy. SYNTHESIS There is an increased frequency of depressive-type symptoms in patients with cancer. In assessing the mood of these patients the physician needs to consider a wide range of factors. Diagnostic issues regarding depression in the medically ill are still being clarified. A good rapport with the patient and an understanding of the emotional conflicts engendered in the individual are important for good management. Active psychotherapeutic strategies include cognitive therapy techniques, management of self-defeating patterns of thought and low morale, and psychosocial group treatments. The side effects of antidepressants in the medically ill may preclude their use, although cyclic antidepressants in a lower dose range have been found to be useful. CONCLUSIONS There is a need for more research into the diagnosis of depression in the medically ill and the use of antidepressants and counselling techniques in patients with cancer. The adequate management of depressed mood which occurs commonly in the patient with advanced cancer requires an integration of biological, psychological and social perspectives. Orchestrating the use of supportive measures, counselling and antidepressants requires both clinical skill and humanity.
19 citations
01 Dec 2004
TL;DR: The most common type of cancer in women is breast cancer as mentioned in this paper, accounting for about a third of all incident cancers in North American women, accounting for approximately 3.5 million cases of breast cancer.
Abstract: Introduction Breast cancer is the most common cancer in North American women, accounting for about a third of all incident cancers. In 2004 in the USA, there are projected to be 215 900 newly diagnosed cases of female breast cancer and 40 110 deaths. During the past 5 years, the mortality rate for breast cancer has declined significantly, most likely due to a combination of wider use of mammographic screening and the diffusion of adjuvant therapy for stage I and II disease. In spite of this improvement in mortality, the number of incident cases of breast cancer is projected to rise with the continued aging of the population, as breast cancer peaks in women in the 8 th decade of life.– Unless major advances in the prevention of breast cancer occur, using chemoprevention and other risk reduction strategies, the absolute number of breast cancer patients and survivors will continue to increase as we move further into the 21 st century. The majority of women with breast cancer are diagnosed with early-stage localized disease. In fact, tumor size at diagnosis has continued to decrease, with very small invasive and non-invasive cancers being detected through mammographic screening. Some series estimate that about 20% of incident cases are now non-invasive (stage 0) ductal carcinoma in situ. However, in spite of these decreases in tumor size and invasiveness, almost all patients diagnosed with breast cancer receive localized breast surgery (breast-conserving surgery and radiation to the breast or a modified radical mastectomy, with or without reconstruction).
19 citations
TL;DR: It is concluded that well-adjusted women diagnosed with breast cancer do not specifically benefit from these types of interventions, and should not be relied on for psychosocial adjustment in the future.
Abstract: The aim of the present study is to compare the effectiveness of experiential-existential group psychotherapy with a social support group for women with a primary breast cancer on psychosocial adjustment. A total of 67 well-adjusted women, who had been operated not earlier than 4 months before start of the study, were randomized into one of the two conditions: participating in the group psychotherapy or in the support group. They were questioned at the start of the study, at the end of the intervention, and 1 year after completion of the intervention. Results at follow-up were mixed: Positive changes were reported for Body Image and Recreation, regardless of type of intervention. Other psychosocial adjustment indicators did not change. In general, we may conclude that well-adjusted women diagnosed with breast cancer do not specifically benefit from these types of interventions.
19 citations
TL;DR: Little research has been done on the long-term psychologic consequences of gynecological cancer, whereas a relatively large number of studies have done on breast cancer.
Abstract: Psychological morbidity in cured cancer patients is seriously underestimated [1–8]. Little research has been done on the long-term psychologic consequences of gynecological cancer, whereas a relatively large number of studies have been done on breast cancer. The latter work has shown that the psychological morbidity in cured patients is high (22%–33%) and that the psychological distress often does not become manifest until 6–9 months after medical treatment [9].
19 citations
Journal Article•
TL;DR: Results show that, in terms of body image, the intervention group scores higher in post-treatment and follow- up, whereas for self-esteem the difference only shows up in the follow-up, the time elapsed variable being relevant.
Abstract: One of the issues of major interest in relation to breast cancer has been patients' adjustment to the changes in body image that treatment produces. The goals of the present study are related to various aspects of body image and self-esteem. These objectives include: a) to examine the effectiveness of a psychosocial intervention designed to enhance body image and raise self-esteem, by comparing an intervention and a control group at each of three measurement points: pre-treatment, post-treatment and follow up, and b) to analyze the influence of sociodemographic and medical (type of surgery and type of treatment) variables on body image and self-esteem. Results show that, in terms of body image, the intervention group scores higher in post-treatment and follow-up, whereas for self-esteem the difference only shows up in the follow-up, the time elapsed variable being relevant. In relation to type of surgery, women with a tumorectomy had a more positive body image than women with a mastectomy.
19 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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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