摘要:

AbstractWorldwide, psychological and social issues in cancer were not the subject of scientific inquiry until the past two decades. Since then, a new subspecialty of oncology has evolved, psycho‐oncology. It addresses two dimensions of cancer: the emotional responses of patients at all stages of disease, as well as their families and caretakers (psychosocial); and the pyschological, social and behavioral factors that may influence cancer morbidity and mortality (psychobiological). Obstacles to development have been the facts of small numbers of clinicians and investigators worldwide and the few valid assessment instruments and research methods available to the biomedical community. These obstacles are increasingly giving way to the louder demand of the public for maximal quality of life in cancer care. Psycho‐oncology is attaining subspeciality status by presently bringing a set of clinical skills in counseling, behavioral and social interventions to oncology, by providing training curricula which teach basic knowledge and skills in the area, and through creating a body of research and scholarly information about clinically relevant issues in the care of patients with cancer. Since it is increasingly recognized that psychological, social and behavioral variables influence treatment outcome, attention will likely to continue to increase. The field must meet the challenges of the 1990's in psychosocial care and availability of services, support for training clinicians and investigators in psycho‐oncology, and implementation of an exciting research agenda. The focus of new research will encourage collaborative investigations combining biological and psychosocial variables, quality of life research in clinical trials, controlled studies of psychotherapeutic, behavioral and psychopharmacologic research, and crosscultural studies that will examine differences in prevention and detection, health care systems, alternative therapies and meta ana

ISSN:1057-9249    

DOI:10.1002/pon.2960010103

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractA study was undertaken to explore the relationship between depression and tumor invasiveness in a group of 45 patients with cancer of the head and neck at different stages. Patients were assessed for depression at the time of their first visit to a tertiary care cancer center, before definitive diagnosis was made and treatment initiated. Depression was assessed by using the DSM‐III derived dysthymia scale of the Millon Clinical Multiaxial Inventory and by clinical interview which elicited symptoms of major depression. We hypothesized that if depression were related to the physical effects of the tumor then patients with more advanced cancer would be more depressed due to associated pain, discomfort and nutritional deficits. Contrary to expectations, results showed that depression scores were distributed equally throughout all stages. However, stage × gender analysis showed a significant effect with females having early stage (1 and 2) cancer being most depressed. Physical symptoms and nutritional factors were not associated with depressed affect but marital status (unmarried) and stress scores were. The high frequency of depression reported in head and neck cancer patients is not necessarily the result of the malignant process or a response to treatment but may be related to premorbid factors of which social support is one variab

ISSN:1057-9249    

DOI:10.1002/pon.2960010104

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe role of stress and related factors in cancer etiology and progression has been a subject of conjecture and hypothesis. We analysed the association of type A/B behavior, which can be viewed as a chronic, repetitive stress response, and cancer mortality, using data from a 22‐year follow‐up of the Western Collaborative Group Study. The unadjusted relative hazard between type A/B behavior and total cancer mortality was 1.53 (p= 0.005), indicating an excess risk of cancer mortality in type A subjects of about 50% over that of type B. However, most or all of the association appeared to be confounded or mediated by other risk factors. Cigarette smoking and age were only weakly correlated with type A/B behavior, yet these two variables were so strongly related to cancer mortality that they accounted for about half of the association of type A/B with cancer mortality. The remaining association was found only for mortality of those cancers which are linked to alcohol consumption, suggesting that this remaining association may operate through a link between type A behavior and alcohol consumption. Thus, an unadjusted association between type A/B behavior and cancer mortality was mostly accounted for by cigarette smoking, age, and possibly alcohol consumpt

ISSN:1057-9249    

DOI:10.1002/pon.2960010105

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractFurther development of existing measures of health‐related quality of life (QL) is indicated. The present study examined the factor structure of the Rotterdam symptom checklist (RSCL), a self‐rating scale developed for determination of QL among cancer patients which was recently recommended by the UK Medical Research Council Cancer Therapy Committee Working Party on Quality of Life. A comparison is also reported of the RSCL with the Hospital Anxiety and Depression Scale (HADS) and the Psychosocial Adjustment to Illness Scale (PAIS) in a separate sample of patients, selected because they showed evidence of psychopathology. The data indicate that the RSCL can be used as a two‐factor measure for assessing psychological and physical morbidity. Scores for both sub‐scales were found to be higher for female patients. An observed positive association between HADS depression scores and the physical symptoms sub‐scale of the RSCL, in our selected sample, suggests some caution is needed when interpreting levels of physical morbidity and depression among cancer patients, as physical symptom scores may be associated with depression‐related somatic symptoms. Although the RSCL does not measure all dimensions of psychosocial functioning, it is a useful and brief method of assessing physical and psychological morbidity in canc

ISSN:1057-9249    

DOI:10.1002/pon.2960010106

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960010107

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960010108

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:1057-9249    

DOI:10.1002/pon.2960010102

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY