ISSN:1057-9249    

DOI:10.1002/pon.2960040202

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractPaediatric oncology patients often experience significant chemotherapy related nausea and vomiting (NV). A number of controlled studies have shown that a variety of behavioural interventions are effective in treating both anticipatory and postchemotherapy NV.The present randomised, controlled‐design study aims to assess the possible therapeutic gains that may be derived from hypnosis while controlling for gains that may be derived from non‐specific therapeutic factors.Thirty paediatric oncology patients (5–17 years of age), following baseline assessment, were randomly assigned to one of three groups—‘treatment as usual’ control group, therapist contact group, and a hypnosis training group—during an identical chemotherapy pulse.Statistical analysis demonstrates the effectiveness of hypnosis for the reduction of anticipatory nausea and vomiting. Therapist contact alone was also found to be effective in reducing anticipatory nausea but it is suggested that this may be a statistical rather than a clinical effect. The results of the present study suggest that hypnosis is effective in the treatment of AN

ISSN:1057-9249    

DOI:10.1002/pon.2960040203

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractCan patient views, obtained through patient focus groups, make a contribution to the design of clinical trials? This paper describes the use of patient focus groups as a method of gaining information for the development of a randomised trial looking at community versus hospital care in breast cancer follow‐up.Focus groups were used as a method of obtaining qualitative data. Quick and easy access to patients was obtained through a local cancer support group network.Initial responses from the focus group participants appeared to be unfavourable to the protocol. In all, more than five issues were raised which might lead to reluctance to cooperate in the trial. Participants identified key issues related to their follow‐up.Changes were made to the protocol addressing the issues raised. It is suggested that where trials require informed consent, using focus groups to find out patients' perceptions at the initial stage may well save time and money, increase participation levels and lead to better outco

ISSN:1057-9249    

DOI:10.1002/pon.2960040204

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractMajor depressive illness, generalised anxiety disorders and adjustment disorders develop in over 25% of cancer patients within the first two or three years of diagnosis. Key research questions are identified and discussed which should lead to more effective ways of recognising, treating and preventing these disorders.

ISSN:1057-9249    

DOI:10.1002/pon.2960040205

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractIt is increasingly recognized that measures of quality of life (QL) need to be integrated in assessments of outcome following treatment for childhood cancer. Requirements for such scales are discussed with respect to four issues: the need to be (i) brief and comprehensive, (ii) reliable and valid, (iii) able to account for developmental changes in meaning of QL and (iv) amenable to proxy ratings. Currently available instruments are reviewed and their advantages and disadvantages considered. In developing new instruments, attention needs to be paid to differences in definitions of QL made by clinicians and families. New instruments must take more account of patient and family perspectives. More multicentre work is called for in order to recruit samples of sufficient size that acceptable levels of reliability and validity can be established.

ISSN:1057-9249    

DOI:10.1002/pon.2960040206

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractIn the present study women at familial risk for breast cancer (N= 26, risk group) underwent psychological assessments on two occasions: immediately prior to mammography screening and a month after notification of their normal results. Assessments included standardized measures of: acute distress; non‐specific distress; intrusive thoughts; and avoidance about breast cancer. Normal risk women not undergoing mammography (N= 27, comparison group) completed the same measures, to provide an indication of concurrent levels of distress in women recruited from the same community. Results revealed that, prior to mammography, the risk group had high levels of acute distress, which were reduced to the level of the comparison group following notification of normal mammography results. On the other hand, despite notification of normal results, the risk group continued to have higher levels of non‐specific distress, avoidance and intrusive thoughts about breast cancer. These results confirm and extend previous reports of high levels of non‐specific distress and intrusive thoughts in women at familial risk for breast cancer. The findings highlight the need for further studies to determine the sources of this distress and its possible negative consequences for these individuals at risk for c

ISSN:1057-9249    

DOI:10.1002/pon.2960040207

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractA psychiatric liaison to the Gynecologic Oncology Service at a major cancer center was begun in July 1991 to improve the psychosocial care. A total of 82 women were evaluated by a psychiatric consultant over a 12‐month period. Most had advanced gynecological disease with poor prognosis. Consultation requests came from the nursing staff (42%), the gynecological fellow (34%) and the attending gynecologist (24%). Reasons for consultations were: difficulty coping (45%), depression (38%), social issues (7%) and ‘other’ (10%). The initial psychosocial issues were: patient‐related problems (62%), staff issues (28%) and family/social issues (10%). The patient‐related problems were: difficulty coping (43%), depression (33%), anxiety (16%) and delirium (8%). Upon initial assessment, the women met DSM‐III‐R diagnoses of adjustment disorder (53%) with depressed mood (32%), with mixed features (12%), with anxious mood (9%), major depression (13%), delirium (12%), panic attack with agoraphobia (4%), dementia (4%), schizophrenia (4%), ‘other’ (5%). After the initial consultation 28% developed delirium. ‘Other’ consisted of two women with a history of substance dependence and borderline personality disorder, one woman with an organic mood disorder and one woman with an interpersonal problem. Psychophar‐macological, behavioral and psychotherapeutic interventions are outlined through description of severa

ISSN:1057-9249    

DOI:10.1002/pon.2960040208

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThis descriptive, retrospective study was undertaken to identify suicide histories in children and adolescents at a pediatric cancer center and to identify potential suicide risk factors in this population. Physicians, nurse practitioners, psychologists and social workers at the Dana‐Farber Cancer Institute were surveyed to identify patients known to have made suicide attempts, successful or not. Medical and psychosocial histories, including specifics of the event, were obtained from a semi‐structured interview with the respondent and a review of the medical chart, and evaluated for psychosocial risk factors. Thirty‐eight clinicians identified 10 patients with suicidal events between 1974 and 1991: two successful suicides, four unsuccessful attempts, two deaths under unclear circumstances and two instances of self‐destructive behavior with unclear intent. Subjects ranged in age from 10 to 27 years at the time of the event (median age 16.34 years) and diagnoses included Hodgkin's disease (4), leukemia (2), Ewing's sarcoma, osteosarcoma, soft tissue sarcoma and neuroblastoma. Psychosocial risk factors or stresses of the current medical situation were present in nine out of the 10 patients (median score, 4 factors). Depression or hopelessness was present in eight patients, and stressful familial events (in addition to patient's illness) such as parental divorce, additional familial illness or financial pressures were present in seven patients. Current medical factors, such as advanced illness/poor prognosis and pain management issues, were present in three and two patients, respectively. Six out of the 10 subjects were off medical treatment at the time of their attempts. Suicide or suicide attempts in this sample indicated that medical factors alone are not adequate to explain the emotional states which may give rise to self‐destructive behavior. Psychosocial stressors from non‐medical sources appear to contribute to increased suicide risk for pediatric cancer patients. The finding that six out of 10 suicide attempts occurred in cancer survivors raises concerns about the special risk to this population. These findings suggest more extensive study is needed of suicidal behavior among pediatric cancer patients and, particularly, survivors of pediatric cancer. In addition to further identification of specific medical and psychosocial factors, the interrelationship between these factors needs to be better understood for its potential to contribute to suicidality in this population. The cumulative effect of chronic stress from medical factors also deserves further in

ISSN:1057-9249    

DOI:10.1002/pon.2960040209

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960040210

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960040213

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY