摘要:

AbstractBone marrow transplantation (BMT) has become an important innovative treatment for hematological malignancies, solid tumors, immunodeficiency diseases and metabolic disorders. It has evolved over the last decade from a controversial research procedure to a standard therapeutic modality, which prolongs remission of some patients and cures others. Historically, the BMT procedure is divided into several stages, each of which have accompanying emotional problems. In providing psychological care for transplant recipients, donors and families, care‐givers must be familiar with the psychological stages of the procedure, the psychological themes such as body image, rebirth and the patient's mechanisms of coping with the extreme stress of such protocols. Its complex medications, high‐dose chemotherapy, total‐body irradiation (TBI), germ‐free environment, graft‐versus‐host disease (GvHD), Broviac or Hickman line catheterization and total parenteral nutrition (TPN), can precipitate significant psychological sequelae with immediate and long‐term consequences. In response to their illness, transplant patients may also develop emotional disturbances of anxiety, depression, agitation, non‐compliance and rare suicidal thoughts. These reactions, and the occasional presence of concurrent psychiatric illness, require recognition and development of guidelines for management.This paper is the first in a series of two and will inform the reader about: (1) the biology, epidemiology, history and economics of BMT; (2) informed consent issues and the psychological/social assessment of patients and families prior to BMT; (3) the psychological care of patients during BMT; and (4) address special issues concerning donation of marrow, donor registries, family issues, children as patients and prevention of staff burn‐out. Part II of this series will review the psychosocial adjustment and quality of life of BMT patients as they convalesce and re‐enter normal daily routines. A summary is given of research into which psychosocial factors predict bett

ISSN:1057-9249    

DOI:10.1002/pon.2960020303

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractAs delineated in Part I of this series, bone marrow transplantation (BMT) is being used as an innovative and often curative treatment for many hematological and solid tumor cancers, and non‐malignant diseases such as aplastic anemia, severe combined immunodeficiency disease and hereditary syndromes (thalassemia and the mucopolysaccharide dyscrasias). Currently there is a small but burgeoning field of literature that is investigating the medical sequelae, psychological, social and sexual adjustment (and quality of life) after having undergone a successful transplant. A knowledge of the long‐term medical toxicity of BMT is mandatory in the light of its influences on psychological convalescence and recovery. Part II of this series (1) briefly describes the long‐term medical sequelae of BMT, (2) addresses clinical papers and research in the area of quality of life after BMT, and (3) explores psychological and psychosocial predictors in BMT adjus

ISSN:1057-9249    

DOI:10.1002/pon.2960020304

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractA total of 117 women attending a gynaecological oncology follow‐up clinic completed the Hospital Anxiety and Depression Scale (HADS), the Courtauld Emotional Control Scale (CECS) and a 72‐item ad hoc questionnaire designed to assess their evaluation of doctor‐patient communication and the perceived impact of diagnosis and treatment. Women who were anxious and/or depressed at follow‐up were more critical of doctor—patient interaction, particularly regarding the amount of information given. Young women, and married or widowed women, had more emotional difficulties and needs, as did those who had had a long remission. Although 47% of the women reported being too shocked to take in details at the time the diagnosis was confirmed, only 3% felt that they had been given too much information at that time and 23% would have preferred more information. During the ensuing month, 39% would have liked further information although 21% did not wish this. In many cases, therefore, there is a need for repeated information giving consultations. Routine use of HADS and CECS may help the clinician to identify and monitor patients most at risk of psychological

ISSN:1057-9249    

DOI:10.1002/pon.2960020305

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractA total of 73 siblings of pediatric cancer patients and their parents completed a questionnaire about the siblings' reactions to the illness of their brother or sister. Descriptive information was obtained about the reactions, stresses, relationships, communication and behavior of the healthy sibling. From this data and from case examples, specific impressions emerged with treatment and research implications. These included the importance of the involvement of the healthy sibling with the ill siblings' treatment and the importance of assessing family interaction style to facilitate effective clinical interventions. Suggestions about direction for future empirical studies were made.

ISSN:1057-9249    

DOI:10.1002/pon.2960020306

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractTelephone counseling of cancer patients has existed on a limited basis for a number of years. One aspect of telephone counseling that has not been adequately explored involves using an outcall strategy, in which the counseling service would call the patient according to a prearranged schedule. Such a strategy could be used to overcome the potentially significant barrier of requiring the patient to proactively call the counseling service. As a preliminary phase in the development of a larger program of research on telephone counseling of cancer patients, two feasibility studies were conducted to assess patient willingness to receive outcall telephone counseling and their willingness to share sensitive psychosocial concerns over the telephone. The results obtained from both feasibility studies suggest that telephone outcalls are feasible for both breast and prostate cancer patients. Additional research is proposed to test the efficacy of psychosocial counseling by telephone using an outcall format.

ISSN:1057-9249    

DOI:10.1002/pon.2960020307

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThe 42 National Cancer Institute Clinical and Comprehensive Cancer Centers were surveyed about their group support programs. All responding centers (81%) offered group support programs, an average of 3.5 groups per center. There were an average of 6.0 members per group. About an equal number of groups were composed of patients or family members only; more groups included both patients and family members. About one‐third of the groups were limited by site, most commonly breast cancer. One‐quarter limited membership by treatment, and a few groups limited membership by stage of disease. Most of the groups were open‐ended in structure. Nearly all groups met with a frequency between weekly and monthly. Support and education were the primary focus of groups, rather than cognitive‐behavioral or psychotherapy. Social workers and nurses led the majority of groups. Almost all of the groups were provided without payment. Implications of the survey's findings for research and clinical applications of support groups for cancer patients are di

ISSN:1057-9249    

DOI:10.1002/pon.2960020308

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractIn the psychopharmacological treatment of depression in cancer patients, mianserin appears to have advantages over other antidepressants. However, it is, claimed to be associated with an unacceptably high incidence of neutropenia. This claim was assessed by investigating the frequency of reported cases of mianserin‐related neutropenia against the estimated prescription figures in South Africa. Simultaneously, a more specific assessment was carried out in the form of a 10‐year retrospective analysis of all patients presenting with neutropenia to the Department of Haematology, Groote Schuur Hospital, South Africa. Ten patients (18% of the total) demonstrated a psychotropic drug‐related neutropenia, and in no instance could mianserin be incriminated. The haematological lesion reversed upon withdrawal of the drug in eight out of these patients as opposed to 12 out of 22 in the non‐drug‐related, idiopathic group. It would appear that the incidence of mianserin‐related neutropenia is no higher than with other psychotropic drugs and, similarly, the condition is reversible. It is concluded that mianserin would therefore be an appropriate first‐line agent in the treatment of depression in cancer patients, subject to suggest

ISSN:1057-9249    

DOI:10.1002/pon.2960020309

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960020310

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960020311

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960020312

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY