摘要:

AbstractFamily function was assessed in 102 families (342 members) of palliative care patients and grouped into classes by a computer‐based taxonomic program. Five classes were defined through the dimensions of cohesiveness, conflict and expressiveness of the Family Environment Scale (FES). One third of families we namedsupportivefor their high cohesiveness; a further 21%resolved conflicteffectively; both of these classes contained low psychological morbidity. Two classes (15%) were clearly dysfunctional:hostilefamilies (6%) were distinguished by high conflict whilesullenfamilies (9%) displayed moderate conflict, poor cohesion and limited expressiveness. These two classes had significantly higher levels of psychological morbidity and poorer social functioning. The remaining class (31%) had intermediate levels of cohesion, expressiveness and conflict (termedordinary) yet more moderate psychosocial morbidity. Screening of families with the FES would facilitate a more family‐centred approach to treatment, with relatively early identification of families at‐risk; preventive interventions would also then be fea

ISSN:1057-9249    

DOI:10.1002/pon.2960030403

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThis review focuses upon possible mediators of the frequently noted associations between psychosocial factors and the progression of breast cancer. First, host‐related endocrine and immunological processes that may play an important role in the carcinogenesis and progression of breast cancer are summarized. Second, the effects of several endocrines on different components of the immune system that have been shown to be related to the course of breast cancer are addressed. Third, studies examining the effect of psychosocial factors on immune function conducted with breast cancer patients and healthy individuals are described. Based on this review, it can be concluded that causal relations between psychosocial stressors, endocrine and immune processes, and breast cancer progression remain to be elucidated. It can be hypothesized that psychosocial stressors influence the course of breast cancer by modulating endocrine processes which are directly related to tumor growth or indirectly related by decreasing immunologic control over tumor development and metastases. Finally, methodological pitfalls that plague this line of research are summarized and recommendations for future psychoneuroimmunologic research in breast cancer are provide

ISSN:1057-9249    

DOI:10.1002/pon.2960030404

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractTreatment of certain cancers by interleukin‐2 (IL‐2) and alpha interferon (INF) is currently widely‐used in oncology and serious psychological side effects of such treatments have been reported. This study attempts to describe and analyse such side effects in a series of hospitalized cancer patients. Fifty‐two patients undergoing a protocol of cisplatinum, intravenous interleukin‐2 infusions and subcutaneous alpha interferon injections for metastatic melanoma and renal cancer were systematically screened for psychiatric disorders before, during and after each of four cycles of 4–5 day EL‐2 infusions. Fatigue was constant and treatment‐limiting in some cases and was highly correlated with depressive symptoms, which were very frequent at the end of the treatment cycle. Patients regularly showed varying degrees of obtundedness at the height of physical symptoms induced by IL‐2. Some patients also had transient, predominantly hallucinatory deliria occurring or persisting several days after the termination of the infusions and complete resolution of concurrent somatic distress; neuroleptics were effective treatment. Certain lymphocyte phenotype counts (total lymphocytes, total CD8 cells, total T3s, stimulated Ts, non‐stimulated Ts) correlatednegativelywith depressive symptomatology whereas fatigue tended to correlate negatively with polymorphonuclear leukocyte counts. Delirium correlatedpositivelywith total CD8 cells. Hallucinatory delirium, but not fatigue or depression, seems to be a direct cerebral effect of the interleukin‐2α interferon combination that is not merely a consequence of the somatic effects. Patients undergoing lymphokine treatments should be carefully screened for psychological side effects and preventive or curative trea

ISSN:1057-9249    

DOI:10.1002/pon.2960030405

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractA prospective cohort study of 2357 women eligible for participation in the UK National Breast Screening Programme was carried out to evaluate the immediate emotional and behavioural effects of attending for routine mammography. Women completed the Hospital Anxiety and Depression Scale (HADS) in the context of a survey by their General Practitionerbeforethey knew they were to receive an invitation to attend screening and again at screening some 6 weeks later. In addition, anad hocHealth Questionnaire was administered when the women attended for screening to assess possible self‐perceived stress‐related behaviour changes in the previous week.2110 (89.5% response rate) women returned the initial postal baseline HADS and 1635 completed the HADS again at screening. Anxiety and depression scales were significantlylowerat screening than at baseline (t= 3.16,p<0.002, 95% CI = 0.07 to 0.31) and (t= 8.46,p<0.0001, 95% CI = 0.32 to 0.52) respectively. Women scoring in the borderline range at baseline were more likely to move into the normal than the clinically significant range for anxiety (χ2= 40.36,p<0.001) and also for depression (χ2= 56.04,p<0.001), and women scoring in the clinically significant range for anxiety were more likely to become normal thanvice versa(χ2= 5.95,p<0.02). The Health Questionnaire indicated that some women reported stress‐related behaviour changes in the week prior to screening, especially those who were most anxious or d

ISSN:1057-9249    

DOI:10.1002/pon.2960030406

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractLife threat or physical injury have been shown to produce post‐traumatic stress symptoms in children. Recent studies have demonstrated that a subset of survivors of pediatric cancer report post‐traumatic stress symptoms years after completing successful treatment. However, it is not clear whether these symptoms represent a response to the perception of life‐threat or to the repeated intrusive procedures that accompany cancer treatment. In this exploratory study, 30 childhood cancer survivors 8 to 19 years old, who were at least 22 months off treatment without recurrence of disease, were evaluated using self‐report questionnaires. The survivor's appraisal of treatment intensity signficantly correlated with the severity of post‐traumatic stress symptoms. When age at the time of diagnosis was evaluated, appraisal of treatment intensity was significantly correlated with symptoms only in those six years old and younger. For children aged seven years or older at the time of diagnosis, duration of treatment was a significant contributor to symptoms. Diagnostic category (leukemia or solid tumor), length of time since completion of treatment and the child's appraisal of life‐threat were not significantly correlated with severity of post‐traumatic stress symptoms. Further study of the impact of intensive pediatric treatment on children and the importance of developmental factors in traumatic response to illness appears to

ISSN:1057-9249    

DOI:10.1002/pon.2960030407

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractRecent studies have suggested that parental responses to pediatric cancer can include symptoms of post‐traumatic stress even years after the end of successful treatment. This paper proposes a family model, based on data about the relationship between post‐traumatic stress symptoms in parents of cancer survivors and the child's perceptions, symptoms and treatment. Parents of 30 childhood cancer survivors 8–19 years old, who were at least 22 months off treatment and disease free after a malignancy, were evaluated using self‐report questionnaires. Neither diagnostic category (leukemia versus solid tumor), nor time since completion of treatment significantly correlated with severity of post‐traumatic stress symptoms reported by parents. Although there was a significant correlation between symptom severity of mothers and fathers, neither mothers nor fathers' scores were significantly correlated with the survivors'. Maternal symptoms were significantly correlated with mothers' trait anxiety, survivors' appraisal of treatment intensity, and with duration of treatment. Further study of the interaction of family variables in parental post‐traumatic response to pediatric illness appears to b

ISSN:1057-9249    

DOI:10.1002/pon.2960030408

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThree hundred undergraduate students read one of 12 vignettes about a hypothetical breast cancer patient, completed the Profile of Mood States (POMS) as they thought she would, and completed a questionnaire (Perception of Medical Patients Questionnaire; PMPQ) designed to elicit their perceptions of her. Vignettes differed according to time since surgery (5 days, 3 months, or 15 months), treatment method (lumpectomy with radiation or mastectomy) and age of the patient (32 or 62 years). As predicted, patients whose surgery occurred most recently were viewed as more distressed than the other patients. Subjects perceived mastectomy patients to have greater sexual problems, be more likely to need counselling, and to be more embarrassed than lumpectomy patients. On the other hand, patients treated with lumpectomy and radiation were rated higher on an index of fatigue than were mastectomy patients. No differences between treatment method were found in terms of the amount of additional emotional support patients would need. Subjects expected younger patients to survive longer and look less ill, but the predicted differences between older and younger patients in terms of likelihood of sexual adjustment problems was not found.

ISSN:1057-9249    

DOI:10.1002/pon.2960030409

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960030410

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960030412

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960030413

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY