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: Research on the risks associated with usual aging and strategies to modify them should help elucidate how a transition from usual to successful aging can be facilitated.
Abstract: Research in aging has emphasized average age-related losses and neglected the substantial heterogeneity of older persons. The effects of the aging process itself have been exaggerated, and the modifying effects of diet, exercise, personal habits, and psychosocial factors underestimated. Within the category of normal aging, a distinction can be made between usual aging, in which extrinsic factors heighten the effects of aging alone, and successful aging, in which extrinsic factors play a neutral or positive role. Research on the risks associated with usual aging and strategies to modify them should help elucidate how a transition from usual to successful aging can be facilitated.
2,809 citations
TL;DR: The effect of psychosocial intervention on time of survival of 86 patients with metastatic breast cancer was studied prospectively and survival plots indicated that divergence in survival began at 20 months after entry, or 8 months after intervention ended.
2,248 citations
TL;DR: Acknowledging that health promotion rests on the shoulders not only of individuals but also of their families and communities means that resources must be committed over the next decade to designing, testing, and implementing interventions in this area.
Abstract: In considering new paradigms for the prevention and treatment of disease and disability, we need to incorporate ways to promote social support and develop family and community strengths and abilities into our interventions. There is now a substantial body of evidence that indicates that the extent to which social relationships are strong and supportive is related to the health of individuals who live within such social contexts. A review of population-based research on mortality risk over the last 20 years indicates that people who are isolated are at increased mortality risk from a number of causes. More recent studies indicate that social support is particularly related to survival postmyocardial infarction. The pathways that lead from such socioenvironmental exposures to poor health outcomes are likely to be multiple and include behavioral mechanisms and more direct physiologic pathways related to neuroendocrine or immunologic function. For social support to be health promoting, it must provide both a sense of belonging and intimacy and must help people to be more competent and self-efficacious. Acknowledging that health promotion rests on the shoulders not only of individuals but also of their families and communities means that we must commit resources over the next decade to designing, testing, and implementing interventions in this area.
1,222 citations
TL;DR: Supportive-expressive group therapy does not prolong survival in women with metastatic breast cancer, but it improves mood and the perception of pain, particularly in women who are initially more distressed.
Abstract: Background Supportive–expressive group therapy has been reported to prolong survival among women with metastatic breast cancer. However, in recent studies, various psychosocial interventions have not prolonged survival. Methods In a multicenter trial, we randomly assigned 235 women with metastatic breast cancer who were expected to survive at least three months in a 2:1 ratio to an intervention group that participated in weekly supportive–expressive group therapy (158 women) or to a control group that received no such intervention (77 women). All the women received educational materials and any medical or psychosocial care that was deemed necessary. The primary outcome was survival; psychosocial function was assessed by self-reported questionnaires. Results Women assigned to supportive–expressive therapy had greater improvement in psychological symptoms and reported less pain (P=0.04) than women in the control group. A significant interaction of treatment-group assignment with base-line psychological scor...
833 citations
TL;DR: Evidence of a bidirectional relationship between cancer and depression, offering new opportunities for therapeutic intervention is found, although studies in this latter area are also divided.
778 citations
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87 citations
TL;DR: Cognitive self-instruction may not be applicable for every cancer patient and all problems, but it is a working hypothesis deserving of further investigation, since self-control and personal responsibility are essential elements in rehabilitation on all levels.
Abstract: Because most cancer patients seem to cope well with the stresses of their illness, including the psychosocial ramifications, it is important to understand what good copers manage to do, as opposed to those patients who simply defend themselves against persistent problems. This requires making a radical distinction between coping and defending, as well as between healthy adaptive resources and latent pathological dispositions. A case report is presented to illustrate how one “supercoper” solved problems by self-instruction. While cognitive self-instruction may not be applicable for every cancer patient and all problems, it is a working hypothesis deserving of further investigation, since self-control and personal responsibility are essential elements in rehabilitation on all levels. One intervention model for “high distress” cancer patients is outlined.
60 citations
54 citations
TL;DR: Close-ended groups that do not include family members and are homogeneous for stage of disease are most useful in counseling for cancer patients and their families.
46 citations
TL;DR: In this article, a study points up the value of open communication among family members in coping with the crisis at all nodal points, especially postdeath restabilization, and points out the importance of communication among families.
Abstract: A study points up the value of open communication among family members in coping with the crisis at all nodal points, especially postdeath restabilization
46 citations