ISSN:1057-9249    

DOI:10.1002/pon.2960020403

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractIn order to examine the impact of corticosteroids upon psychiatric symptomatology in cancer patients, we prospectively studied two groups: 50 cancer patients with epidural spinal cord compression (ESCC) receiving a standard tapering course of high‐dose dexamethasone (i.e. 100 mg loading dose followed by 96 mg per day tapered to 0 mg over 3–4 weeks), and a comparison group of 50 patients with the same cancer diagnoses and a similar extent of metastatic disease but without ESCC who did not receive dexamethasone. Psychiatric disorder, psychological distress, pain, mental status, physical performance status, medical events, and psychotropic and analgesic use were assessed in both groups at four points during the course of corticosteroid therapy or hospitalization. Measures included: (1) DSM‐III‐R psychiatric diagnosis; (2) Brief Psychiatric Rating Scale; (3) Hamilton Depression Scale; (4) Hamilton Anxiety Rating Scale; (5) Profile of Mood States; (6) Memorial Pain Assessment Card; (7) Mini‐Mental State Examination; and (8) Karnofsky Performance Status Score. While the overall rate of DSM‐III‐R psychiatric disorders was not significantly different between groups, patients receiving corticosteroids had a significantly greater incidence of major depressive syndromes (x2= 6.08,p<0.05), in particular organic mood disorder—depressed (x2= 6.40,p<0.05). There was also a tendency for a greater incidence of delirium (x2= =p<0.10) in the corticosteroid group. The corticosteroid group was significantly more depressed than the comparison group over time as measured by the non‐somatic items of the Hamilton Depression Rating Scale (F= 3.98,p<0.02), and more anxious, as measured by the non‐somatic items of the Hamilton Anxiety Rating Scale (p<0.10). Thus, a tapering regimen of high‐dose corticosteroids has an influence on the incidence and nature of neuropsychiatric disturbance in cancer patients with ESCC, resulting in a significantly greater incidence of depressive s

ISSN:1057-9249    

DOI:10.1002/pon.2960020404

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractColorectal cancer patients are faced with the debilitating consequences of either sphincter‐sacrificing or sphincter‐conserving surgery. The question central to the current literature review is: what is the prevalence of physical, psychological, social and sexual dysfunction among colorectal cancer patients with a colostoma (ostomates) compared with those patients whose sphincter function has been conserved (non‐ostomates). Although the extant literature yields some inconsistent findings, a number of clear trends can be identified: (a) both patient groups are troubled by frequent or irregular bowel movements and diarrhea, and consequently often require dietary restrictions; (b) ostomates report higher levels of psychological distress than do non‐ostomates; (c) psychological problems tend to be more frequent among younger patients and among women; (d) while both ostomates and nonostomates report restrictions in their level of social functioning, such problems appear to be more prevalent among patients with a colostoma; (e) the sexual functioning of male colostomists is consistently more impaired than that of patients with intact sphincters; and (f) a considerable number of women whose sphincter function has been sacrificed suffer from dyspareunia. There is need for more methodologically sound studies that: (1) employ well validated quality‐of‐life measures; (2) assess patients' quality of life prospectively in order to examine patients' psychosocial adaptation over time; and (3) identify those subgroups of patients who are at greatest risk to the adverse psychosocial sequalae of the disease and its surgica

ISSN:1057-9249    

DOI:10.1002/pon.2960020405

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractMARIANNE J. BRADYThe examination of psychosocial adjustment in cancer patients requires focusing upon both negative psychosocial sequelae, such as anxiety and depression, and positive sequelae, such as improvements in life outlook or interpersonal relationships. Both positive and negative psychosocial, physical and functional change following the diagnosis of cancer was assessed in a sample (n= 133) of individuals with malignant disease undergoing evaluation for bone marrow transplantation. Positive psychosocial sequelae were frequently reported. Comparison of a subset of cancer patients (n= 60) with a matched group of individuals without a history of cancer (i.e. ‘controls’), revealed that controls also reported a surprising degree of positive psychosocial change across a given period of time. The fact that cancer patients equalled or exceeded controls in the likelihood of reporting positive psychosocial change was, however, noteworthy given the context of physical and functional decline shown by cancer patients. It is concluded that cancer should not be viewed as a stressor with uniformly negative outcomes but rather as a transitional event which creates the potential for both positive and negative cha

ISSN:1057-9249    

DOI:10.1002/pon.2960020406

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractSurveys discussing information needs and decision‐making preferences were administered to 50 children with cancer (ages 8–17) and 60 accompanying parents. Children wanted information on all aspects of their disease and its treatment, particularly prognosis. 76% of children wanted to be told a percent chance for cure, no matter what it was. Only 38% of parents wanted their children to be given this information (p<0.01). 95% of patients wanted to be told if they were terminally ill. The majority felt that the treatment decision was the physician's. Although 96% of patients did not want to make their own decisions about curative therapy, 63% of adolescents (≥13) wanted to make their own decisions about palliative therapy vs. 28% of younger patients (p= 0.018). Patients felt that people should be allowed to make decisions about participation in medical research at age 14, for treatment of minor medical problems at 16, and to refuse potentially curative therapy for cancer at 17. Parents often want to shield their children from adverse information, but most children want to be fully informed about their disease. Children usually do not want to make decisions about their initial therapy, but many feel that they should decide about palli

ISSN:1057-9249    

DOI:10.1002/pon.2960020407

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractAt the age of 12 (in 1960) I developed a neuroblastoma, which later recurred resulting in prolonged hospitalisation. My natural curiosity led me to ask numerous questions about my condition and treatment but the doctors and nurses treating me would not give me the information I required. Although this was normal practice at the time I feel it was a misguided policy. There have been considerable improvements in communication since then but I still meet patients—either professionally or through cancer self help groups who feel that they have not been given adequate information. I have therefore written this report to document the problems that may arise through poor communicatio

ISSN:1057-9249    

DOI:10.1002/pon.2960020408

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractIn a series of brief clinical accounts, this article elaborates the thesis that cancer patients' intolerance of the side effects of chemotherapy is not merely the effect of the drugs' toxicity but also a way of displacing onto the treatment the fears and anxieties related to the disease. In relational terms, the rejection reaction to the side effects may be a ‘pretext’ for seeking psychological support and in some cases the occasion for initiating psychother

ISSN:1057-9249    

DOI:10.1002/pon.2960020409

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960020410

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960020411

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960020412

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY