Psycho-oncology
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This study investigated how parents' preferred level of control in treatment decision-making is related to their personal health care involvement and to their decision to use complementary therapies (CTs) for their child. One hundred-eighteen parents of pediatric oncology patients completed an anonymous CT survey. The Krantz Health Opinion Survey (KHOS) was used to determine parents' preferred involvement in personal health care, and the Control Preferences Scale for Pediatrics (CPS-P) measured preferred role in pediatric treatment decision-making. ⋯ The hypothesized relationship between CT use and parents' own health care involvement was partially supported. Preference for control in decision-making was not associated with CT use. These findings provide validation for the newly developed CPS-P and indicate that parents' decisions to use CT for their child are related in part to individual health care preferences.
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A social-cognitive processing model was used to examine the association of social support with intrusive thoughts and avoidance in predicting adjustment in 53 patients receiving an experimental vaccine for the treatment of either metastatic melanoma (n=24) or metastatic renal cell cancer (n=29). Social support, intrusive thoughts/avoidance, psychological distress and quality of life were assessed on the day of the first treatment, on the day of the final treatment, and 1 month after the end of treatment during a routine follow-up visit. Social support at the beginning of treatment was negatively associated with psychological distress and positively associated with mental health quality of life (QOL) 1 month after treatment, and these associations were mediated by intrusive thoughts/avoidance at the end of treatment. ⋯ These results suggest that social support buffers the negative association between intrusive thoughts/avoidance and psychological adjustment. Overall, the results are consistent with a social-cognitive processing model of post-trauma reactions among cancer patients. Our results highlight the need to assess patients' perceived support and to further develop and assess the benefits of interventions to increase patients' supportive networks and to facilitate cognitive processing of the cancer experience.
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There is a paucity of research that has directly examined the role of the health professional in dealing with a terminally ill patient's wish to hasten death (WTHD) and the implications of this for the support and services needed in the care for a dying patient. Themes to emerge from a qualitative analysis of interviews conducted on doctors (n=24) involved in the treatment and care of terminally ill patients were (i). the doctors' experiences in caring for their patients (including themes of emotional demands/expectations, the duration of illness, and the availability of palliative care services); (ii). the doctors' perception of the care provided to their respective patients (comprising themes concerning satisfaction with the care for physical symptoms, for emotional symptoms, or overall care); (iii). the doctors' attitudes to euthanasia and (iv). the doctors' perception of their patients' views/beliefs regarding euthanasia and hastened death. ⋯ This exploratory study presents a set of descriptive findings identifying themes among a small group of doctors who have been involved in the care of terminally ill cancer patients, to investigate factors that may be associated with the WTHD among these patients. The pattern of findings suggest that research investigating the doctor-patient interaction in this setting may add to our understanding of the problems (for patients and their doctors) that underpins the wish to hasten death in the terminally ill.
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Comparative Study
Experience with breast cancer, pre-screening perceived susceptibility and the psychological impact of screening.
This prospective study examined whether the psychological impact of organized mammography screening is influenced by women's pre-existing experience with breast cancer and perceived susceptibility (PS) to the disease. From a target population of 16,886, a random sample of women with a normal screening finding and all women with a false positive or a benign biopsy finding were included (N=1942). Data were collected with postal questionnaires 1-month before screening invitation and 2 and 12 months after screening. ⋯ Furthermore, they became more frequent in breast self-examination (BSE) despite a simultaneous decrease in BSE self-efficacy. Our findings suggest that women with high PS and women with false positive screening finding may need individualized counseling and follow-up as much as women with a family history of breast cancer. Besides medical risk factors, women's own perceptions of susceptibility should be discussed during the screening process.
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Comparative Study
Psychosocial and demographic predictors of quality of life in a large sample of cancer patients.
In recent years, there has been increasing emphasis on understanding how the cancer experience affects individuals' quality of life (QOL). The goal of this study was to assess the QOL and to identify psychosocial predictors of QOL among a large sample of patients with a variety of cancers. Specifically, we assessed the unique contribution of demographic variables, medical variables, and social support on patients' QOL and psychological adjustment. ⋯ Demographic variables (age, gender, marital status, education) were generally associated with measures of adjustment and QOL whereas medical variables (time since diagnosis, recurrence status, treatment variables, stage of disease) were not. Patients with more support reported less anxiety and depression and better QOL in the mental health domain, independent of demographic and medical variables. Assessing patients' level of social support may help to identify patients at risk for distress.