High levels of cancer specific distress have been found before and after genetic counseling for breast cancer. This study investigated the process of reducing distress during 111 genetic counseling consultations for familial breast cancer. Consultations were audiotaped, transcribed, and a detailed coding system developed to measure cues of emotional distress from the patient, and consultant (clinical geneticist or genetic counselor) behaviors before and after the cues. At least 1 emotional cue was given in 64 consultations, with a median of 1 cue per consultation. More emotional cues of distress occurred when the consultant responded empathetically to the first cue of distress. Satisfaction outcomes were largely positive regardless of the consultant's attentiveness to distress. Postconsultation depression scores were significantly reduced if more empathic responses were given, but anxiety remained the same. These results are discussed and recommendations are made for improving patient care. 相似文献
This study examined changes in sexual functioning and mood disturbance among women who have been treated for gynecological cancer and who participated in a 12-week group intervention for psychosexual problems. The Changes in Sexual Functioning Questionnaire (CSFQ) assessed the sexual functioning, and the Profile of Mood States (POMS) assessed the mood disturbance of 19 women at baseline who completed follow-ups conducted posttreatment and three-month posttreatment. The results showed that the women improved significantly in their CSFQ total scores after being provided with the group therapy intervention at the posttreatment assessment (p < .01), and a statistical trend (p < .10) suggested continued improvement in CSFQ total scores at the three months posttreatment follow-up. Women's POMS total mood disturbance scores improved significantly at the posttreatment assessment (p = .01), but did not show significant improvement at the 3-month posttreatment follow-up. These results suggest that this group intervention achieved its main goal in treating sexual dysfunction as well as mood disturbance, but these improvements dissipated over time and may require further intervention in order to be maintained. 相似文献
Thirty women who had prophylactic oophorectomy (PO) and thirty women undergoing ovarian cancer surveillance (OCS) completed a one-time in-depth telephone interview exploring information gathering and decision-making processes. There were close similarities between groups, including age, race, marital status, education, menopausal status, number undergoing genetic testing for BRCA mutations, and number of prophylactic mastectomies. The majority of participants indicated overall satisfaction with their final decision. However, many described the information gathering process as frustrating and anxiety provoking. Participants in both groups expressed a need to process medical information within the context of individual psychosocial needs and personal perceptions and experiences. There were recurrent themes with regard to informational and psychosocial needs and personal perceptions and experiences that impacted decision-making process for these women. The present paper is a companion paper to Swisher et al. (J Repr Med 2001, 46:87–94) with the focus of this paper to illustrate the medical informational processing needs identified by this group of women. 相似文献
The potential for benefits to be construed under stressful circumstances has become a topic of interest for researchers studying psychological reactions to adversity. This paper examines benefit-construal following one such stressful event—cancer. A simple framework is presented to organize qualitative and quantitative data from various literatures, including psychology, nursing, oncology, and social work, into 3 areas in which cancer survivors frequently report deriving benefits: life perspective, interpersonal relationships, and the self. This typology helps to clarify the extent and nature of benefit-finding in cancer survivors and provides directions for future research. 相似文献
It is well known that children treated for cancer are at risk for cognitive and functional impairments. Such research is largely based on studies of late effects in school-aged or older children. However, far less is known about executive function weaknesses in preschool-aged children treated for cancer. Thus, the aim of this study was to examine executive functioning in a clinically referred sample of young oncology patients, and its association with broader domains of functioning. Data from 61 young children with cancer, who were referred for clinical cognitive evaluations, were abstracted and included in this study. Patients were 5.00 years of age (SD = 0.72) at assessment, 54.1% male, and two-thirds (63.9%) had been treated for brain tumors. Most executive functions were significantly discrepant from the mean, with 47.5% of preschoolers having parent-reported working memory concerns within the clinically significant range. There were no differences in executive functioning based on diagnosis or treatment status. Parent-reported executive functioning was strongly correlated with global intelligence and adaptive functioning, with some indices also associated with nonverbal problem solving and pre-academic skills. Ultimately, results indicate the presence of emerging weaknesses in executive functioning in young children with cancer, and add to a growing body of literature highlighting the potential cognitive and behavioral risks associated with a cancer diagnosis in early childhood. 相似文献
Objectives: Evidence suggests that disgust responses, known to negatively affect psychological wellbeing, may differ in people with cancer. We performed the first quantitative investigation of three discrete types of disgust trait – disgust propensity, sensitivity and self-directed disgust – in people diagnosed with a broad range of cancers (versus cancer-free controls), and explored their associations with psychological wellbeing.
Design: In a cross-sectional survey design, 107 participants with heterogeneous cancer diagnoses, recruited from cancer charities and support groups, were matched with cancer-free controls by age and gender.
Outcome measures: Measures of the three disgust traits were taken alongside measures of anxiety and depression.
Results: Disgust sensitivity and physical self-disgust were significantly higher in the cancer than control sample, while disgust propensity and behavioural self-disgust were lower. The disgust traits had a different pattern of associations to psychological wellbeing across the two groups, with disgust sensitivity predicting depressive symptoms to a significantly greater extent in the cancer than control group.
Conclusions: People with cancer differ from matched controls in their disgust responses and these responses have significant predictive relationships with aspects of their psychological wellbeing. The results suggest that emotion-based interventions may be useful for improving psychological wellbeing in people with cancer. 相似文献