Psychological Interventions for Cancer Patients to Enhance the Quality of Life
01 Aug 1992-Journal of Consulting and Clinical Psychology (American Psychological Association)-Vol. 60, Iss: 4, pp 552-568
TL;DR: Experimental and quasi-experimental studies of psychological interventions are reviewed, and discussion of treatment components and mechanism is offered.
Abstract: Although the thrust of the nation’s cancer objectives for the year 2000 is prevention and screening, each year approximately 1 million Americans are diagnosed and must cope with the disease and treatments. They do so with the aid of family, friends, and the health care system, but accumulating data suggest that psychological interventions may be important for reducing emotional distress, enhancing coping, and improving “adjustment.” Experimental and quasi-experimental studies of psychological interventions are reviewed, and discussion of treatment components and mechanism is offered. A final section discusses future research directions and challenges to scientific advance.
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TL;DR: Path analyses suggested that several coping reactions played mediating roles in the effect of optimism on distress; acceptance and the use of humor prospectively predicted lower distress; denial and disengagement predicted more distress.
Abstract: At diagnosis, 59 breast cancer patients reported on their overall optimism about life; 1 day presurgery, 10 days postsurgery, and at 3-, 6-, and 12-month follow-ups, they reported their recent coping responses and distress levels. Optimism related inversely to distress at each point, even controlling for prior distress. Acceptance, positive reframing, and use of religion were the most common coping reactions; denial and behavioral disengagement were the least common reactions. Acceptance and the use of humor prospectively predicted lower distress; denial and disengagement predicted more distress. Path analyses suggested that several coping reactions played mediating roles in the effect of optimism on distress. Discussion centers on the role of various coping reactions in the process of adjustment, the mechanisms by which dispositional optimism versus pessimism appears to operate, third variable issues, and applied implications.
1,779 citations
TL;DR: Bereavement, sleep disturbance, disability, prior depression, and female gender appear to be important risk factors for depression among elderly community subjects despite the methodologic limitations of the studies and this meta-analysis.
Abstract: OBJECTIVE: The goal of this study was to determine risk factors for depression among elderly community subjects. METHOD: MEDLINE and PsycINFO were searched for potentially relevant articles published from January 1966 to June 2001 and from January 1967 to June 2001, respectively. The bibliographies of relevant articles were searched for additional references. Twenty studies met the following six inclusion criteria: original research reported in an English or French publication, study group of community residents, age of subjects 50 years or more, prospective study design, examination of at least one risk factor, and use of an acceptable definition of depression. The validity of studies was assessed according to the four primary criteria for risk factor studies described by the Evidence-Based Medicine Working Group. Information about group size at baseline and follow-up, age, proportion of men, depression criteria, exclusion criteria at baseline, length of follow-up, number of incident cases of depression,...
1,248 citations
Cites background from "Psychological Interventions for Can..."
...Such interventions might include education about the significance of the risk factors, bereavement counseling and support (35), new skills training, “maintenance of routines” protocols (36), enhancement of social supports (37), individual or group therapy to facilitate adjustment to loss of function (38), and sleep enhancement protocols (39)....
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TL;DR: This work identified essential elements of collaborative management of chronic illness in light of behavioral principles and empirical evidence about enhancement of self-care, and discussed critical next steps to improve care of Chronic illness in organized health care systems.
Abstract: In chronic illness, day-to-day care responsibilities fall most heavily on patients and their families. Effective collaborative relationships with health care providers can help patients and families better handle self-care tasks. Collaborative management is care that strengthens and supports self-care in chronic illness while assuring that effective medical, preventive, and health maintenance interventions take place. In this paper, the following essential elements of collaborative management developed in light of behavioral principles and empirical evidence about effective care in chronic illness are discussed: 1) collaborative definition of problems, in which patient-defined problems are identified along with medical problems diagnosed by physicians; 2) targeting, goal setting, and planning, in which patients and providers focus on a specific problem, set realistic objectives, and develop an action plan for attaining those objectives in the context of patient preferences and readiness; 3) creation of a continuum of self-management training and support services, in which patients have access to services that teach skills needed to carry out medical regimens, guide health behavior changes, and provide emotional support; and 4) active and sustained follow-up, in which patients are contacted at specified intervals to monitor health status, identify potential complications, and check and reinforce progress in implementing the care plan. These elements make up a common core of services for chronic illness care that need not be reinvented for each disease.
1,240 citations
Cites background from "Psychological Interventions for Can..."
...Interventions that improve outcomes of chronic illness have been developed on the basis of social learning and self-regulation theories (7-14)....
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...In addition to improved disease outcomes, many studies (7, 10, 22, 24, 39, 48, 49) have found that behavioral interventions improve psychosocial outcomes....
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...setting goals and implementing an action plan (7, 10, 59, 60)....
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...For many chronic conditions, interventions developed on the basis of these principles have been shown to improve medical, emotional, and functional outcomes (7, 18-40), particularly when providers and patients work together toward shared goals....
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TL;DR: The authors tested effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer, finding that the intervention reduced prevalence of moderate depression and increased generalized optimism.
Abstract: The authors tested effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer. The intervention reduced prevalence of moderate depression (which remained relatively stable in the control condition) but did not affect other measures of emotional distress. The intervention also increased participants' reports that having breast cancer had made positive contributions to their lives, and it increased generalized optimism. Both remained significantly elevated at a 3-month follow-up of the intervention. Further analysis revealed that the intervention had its greatest impact on these 2 variables among women who were lowest in optimism at baseline. Discussion centers on the importance of examining positive responses to traumatic events--growth, appreciation of life, shift in priorities, and positive affect-as well as negative responses.
832 citations
01 Jan 1995
TL;DR: In this article, meta-analytic methods were used to synthesize the results of published randomized, controlled-outcome studies of psychosocial interventions with adult cancer patients, including behavioral interventions, nonbehavioral counseling and therapy, informational and educational methods, organized social support provided by other patients, and other non-hospice interventions.
Abstract: Meta-analytic methods were used to synthesize the results of published randomized, controlledoutcome studies of psychosocial interventions with adult cancer patients. Forty-five studies reporting 62 treatment-control comparisons were identified. Samples were predominantly White, female, and from the United States. Beneficial effect size ds were .24 for emotional adjustment measures, .19 for functional adjustment measures, .26 for measures of treatment- and diseaserelated symptoms, and .28 for compound and global measures. The effect size of .17 found for medical measures was not statistically significant for the few reporting studies. Effect sizes for treatment-control comparisons did not significantly differ among several categories of treatment: behavioral interventions, nonbehavioral counseling and therapy, informational and educational methods, organized social support provided by other patients, and other nonhospice interventions. Though the field of psychosocial oncology is relatively young, intervention studies and indeed even narrative reviews of those studies are no longer rare. Meta-analytic investigations, however, are conspicuously absent from the literature. In the present article, the results of treatment-control studies of psychosocial interventions with adult cancer patients are assessed meta-analytically. The focus is on the effects of nonpharmacological interventions intended to improve the quality of life of adults who have already been diagnosed with
817 citations
References
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TL;DR: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out and a wide variety of psychiatric rating scales have been developed.
Abstract: The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations." Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15These have been well summarized in a review article by Lorr11on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
35,176 citations
01 Jan 1970
TL;DR: The STAI as mentioned in this paper is an indicator of two types of anxiety, the state and trait anxiety, and measure the severity of the overall anxiety level, which is appropriate for those who have at least a sixth grade reading level.
Abstract: The STAI serves as an indicator of two types of anxiety, the state and trait anxiety, and measure the severity of the overall anxiety level.The STAI, which is appropriate for those who have at least a sixth grade reading level, contains four-point Likert items. The instrument is divided into two sections, each having twenty questions. Approximately 15 minutes are required for adults to complete the both STAI. The number on the scale is positively correlated to the anxiety related to in the question.
24,997 citations
TL;DR: Initial scale development and reliability studies of the items and the scale scores are reported on.
Abstract: • The Schedule for Affective Disorders and Schizophrenia (SADS) was developed to reduce information variance in both the descriptive and diagnostic evaluation of a subject. The SADS is unique among rating scales in that it provides for (1) a detailed description of the features of the current episode of illness when they were at their most severe; (2) a description of the level of severity of manifestations of major dimensions of psychopathology during the week preceding the evaluation, which can then be used as a measure of change; (3) a progression of questions and criteria, which provides information for making diagnoses; and (4) a detailed description of past psychopathology and functioning relevant to an evaluation of diagnosis, prognosis, and overall severity of disturbance. This article reports on initial scale development and reliability studies of the items and the scale scores.
5,623 citations
TL;DR: The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts.
Abstract: The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.
4,882 citations
Book•
01 Jan 1970TL;DR: Yalom as mentioned in this paper described the course of therapy from both the patient's and the therapist's viewpoint in Encounter Groups: First Facts (1973) and Every Day gets a Little Closer: A Twice-Told Therapy (1974).
Abstract: This book first appeared in 1970 and has gone into two further editions, one in 1975 and this one in 1985. Yalom is also the author of Existential Psychotherapy (1980), In-patient Group Psychotherapy (1983), the co-author with Lieberman of Encounter Groups: First Facts (1973) and with Elkin of Every Day Gets a Little Closer: A Twice-Told Therapy (1974) (which recounts the course of therapy from the patient's and the therapist's viewpoint). The present book is the central work of the set and seems to me the most substantial. It is also one of the most readable of his works because of its straightforward style and the liberal use of clinical examples.
4,235 citations
"Psychological Interventions for Can..." refers background in this paper
...When group therapies “work,” the role of the therapist (and these qualities) shift to the group participants (Yalom, 1975)....
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