1
|
Langevin HM, Berger A, Edwards E. Interface of resilience with other related concepts in physiological and psychosocial/spiritual domains. Stress Health 2023; 39:10-13. [PMID: 37237422 DOI: 10.1002/smi.3257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Helene M Langevin
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, Maryland, USA
| | - Ann Berger
- NIH Clinical Center, Bethesda, Maryland, USA
| | - Emmeline Edwards
- National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH), Bethesda, Maryland, USA
| |
Collapse
|
2
|
González-Herrera A, Pujol-Ribera E, Esteva M, Ruiz-Marcos L, March S. Colorectal cancer: a qualitative study of coping strategies used by survivors, with associated social determinants. Arch Public Health 2023; 81:111. [PMID: 37331995 DOI: 10.1186/s13690-023-01104-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/06/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Colorectal cancer survivors have to develop coping strategies during the diagnosis and survivorship period. This study aims to identify coping strategies in patients with colorectal cancer, in particular the differences between coping strategies during the disease and throughout survival. It also aims to investigate the impact of some social determinants on coping strategies and critically reflect on the influence of positive psychology. METHODS Qualitative study with in-depth interviews of a purposive sample of 21 colorectal cancer survivors in Majorca (Spain), developed between 2017-2019. Data was analysed using interpretive thematic analysis. RESULTS We observed different coping strategies during the stages of disease and survival. However, striving toward acceptance and adaptation when facing difficulties and uncertainty, predominate in both stages. Confrontational attitudes are also considered important, as well as encouraging positive rather than negative feelings, which are considered unhelpful and to be avoided. CONCLUSIONS Although coping during illness and survival can be classified into common categories (problem and emotion-centred strategies), the challenges of these stages are faced differently. Age, gender and the cultural influence of positive psychology strongly influence both stages and strategies.
Collapse
Affiliation(s)
| | - Enriqueta Pujol-Ribera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Gerència Territorial de Barcelona, Institut Català de La Salut, Barcelona, Spain
| | - Magdalena Esteva
- Primary Care Research Unit, Majorca Department of Primary Care, Baleares Health Service (IbSalut), Palma, Majorca, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma, Majorca, Spain.
| | - Lorena Ruiz-Marcos
- Faculty of Political Sciences and Sociology, Complutense University of Madrid, Pozuelo de Alarcón, Madrid, Spain
| | | |
Collapse
|
3
|
Luna MJ, Ameli R, Sinaii N, Cheringal J, Panahi S, Berger A. Gender Differences in Psycho-Social-Spiritual Healing. J Womens Health (Larchmt) 2019; 28:1513-1521. [PMID: 31502927 PMCID: PMC6862956 DOI: 10.1089/jwh.2019.7837] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Many individuals exhibit significant distress in response to serious and/or life-limiting illness. However, there are others who make life-transforming changes, which involve healing experiences in the psychological, social, and spiritual domains of life regardless of illness outcome. The aim of the present study is to determine if there are any differences in psycho-social-spiritual healing between genders. Materials and Methods: The NIH Healing Experiences in All Life Stressors (NIH-HEALS), a 35-item measure of psycho-social-spiritual healing, is composed of three factors: Connection, Reflection & Introspection, and Trust & Acceptance. NIH-HEALS and a demographic questionnaire were administered to 193 patients with serious and/or life-limiting illness at the National Institutes of Health Clinical Center. Results: In response to NIH-HEALS, men and women significantly differed on the Reflection & Introspection factor. Women reported increased enjoyment of mind–body practices (p < 0.001), compassion (p = 0.005), gratitude (p = 0.014), and a desire to be more positive (p = 0.044) compared to men. Men rated their pain levels (p = 0.035) and severity of illness (p = 0.016) higher and their overall level of health (p = 0.010) poorer compared to women. Women's responses to items regarding compassion (rs = 0.37, p < 0.001) and gratitude (rs = 0.24, p = 0.015) correlated positively with better overall health ratings. Conclusion: Men and women show some differences in their self-reported psycho-social-spiritual healing, which may have implications when designing interventions aimed at promoting a healing experience in the context of serious and life-limiting illness.
Collapse
Affiliation(s)
- María José Luna
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Rezvan Ameli
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ninet Sinaii
- Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Julia Cheringal
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Samin Panahi
- Clinical Center, National Institutes of Health, Bethesda, Maryland
| | - Ann Berger
- Clinical Center, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
4
|
Lopez AJ, Butow PN, Philp S, Hobbs K, Phillips E, Robertson R, Juraskova I. Age‐related supportive care needs of women with gynaecological cancer: A qualitative exploration. Eur J Cancer Care (Engl) 2019; 28:e13070. [DOI: 10.1111/ecc.13070] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 03/14/2019] [Accepted: 03/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Anna‐Lena J. Lopez
- Centre for Medical Psychology and Evidence‐based Decision‐making, School of Psychology The University of Sydney Sydney Australia
- Psycho‐Oncology Co‐Operative Research Group The University of Sydney Sydney Australia
| | - Phyllis N. Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making, School of Psychology The University of Sydney Sydney Australia
- Psycho‐Oncology Co‐Operative Research Group The University of Sydney Sydney Australia
| | - Shannon Philp
- Lifehouse Gynaecological Oncology Group, and Sydney Nursing School The University of Sydney Sydney Australia
| | - Kim Hobbs
- Department of Gynaecological Cancer Westmead Hospital Sydney Australia
| | - Emily Phillips
- Department of Gynaecological Cancer Westmead Hospital Sydney Australia
| | | | - Ilona Juraskova
- Centre for Medical Psychology and Evidence‐based Decision‐making, School of Psychology The University of Sydney Sydney Australia
- Psycho‐Oncology Co‐Operative Research Group The University of Sydney Sydney Australia
| |
Collapse
|
5
|
Head KJ, Iannarino NT. "It Changed Our Outlook on How We Want to Live": Cancer as a Transformative Health Experience for Young Adult Survivors and Their Family Members. QUALITATIVE HEALTH RESEARCH 2019; 29:404-417. [PMID: 30234430 DOI: 10.1177/1049732318800674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although young adult cancer survivors (YACSs) and their families face unique psychosocial and health-related challenges related to cancer, little is known about how the illness experience of cancer may positively transform their mental, physical, and social well-being following primary treatment. We conducted individual qualitative interviews with 30 YACSs and 21 of their family members. Participants described positive transformations as (a) perspective shifts on health and risk, (b) behavior changes toward more proactive healthy living, and (c) opportunities for more open communication about wellness. Few participants reported little to no transformation based on a fatalistic view of their diagnosis. Our findings illuminate important implications for health promotion and support in this population, including the role health care providers can play following primary treatment. We also discuss how YACSs can serve as important advocates for others and the need for more work exploring how and why positive illness transformations take place.
Collapse
Affiliation(s)
- Katharine J Head
- 1 Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, USA
| | | |
Collapse
|
6
|
Ameli R, Sinaii N, Luna MJ, Cheringal J, Gril B, Berger A. The National Institutes of Health measure of Healing Experience of All Life Stressors (NIH-HEALS): Factor analysis and validation. PLoS One 2018; 13:e0207820. [PMID: 30540764 PMCID: PMC6291293 DOI: 10.1371/journal.pone.0207820] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/06/2018] [Indexed: 11/18/2022] Open
Abstract
Two hundred patients with severe and/or life-threatening disease were recruited form the NIH Clinical Center and participated in the validation of the NIH-HEALS, which included exploratory factor analysis, principal component analysis, reliability, convergent validity, and divergent validity analyses. Item-reducing principal components analysis and internal consistency and split-half reliability demonstrated excellent internal consistency and split-half reliability (Cronbach's alpha = 0.89, split-half reliability = 0.95). Exploratory factor analysis revealed a three-factor structure, namely Connection (including religious, spiritual, and interpersonal), Reflection & Introspection, and Trust & Acceptance. Seven items were not retained. Convergent and divergent validity of 35-item NIH-HEALS against other validated measures of healing and spirituality provided strong evidence for its validity. As predicted, the Healed factor of the Self-Integration Scale (SIS), and Meaning, Peace, and Faith factors of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12 Scale (FACIT-SP12) were all positively and significantly correlated with the NIH-HEALS and its three factors. Divergent validity was also confirmed by the significant negative correlation between the NIH-HEALS and the Codependent factor on the SIS. Confirmatory Factor Analyses revealed good model fit by GFI (0.96), adjusted GFI (0.95), SRMR (0.077), and RMSEA (0.065), supporting the use of the NIH-HEALS with 35 items.
Collapse
Affiliation(s)
- Rezvan Ameli
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ninet Sinaii
- Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - María José Luna
- Northwestern University, Chicago, Illinois, United States of America
| | - Julia Cheringal
- Walter Reed National Military Medical Center, Bethesda, MD, United States of America
| | - Brunilde Gril
- National Cancer Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Ann Berger
- Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| |
Collapse
|
7
|
Do cancer patients use the term resilience? A systematic review of qualitative studies. Support Care Cancer 2018; 27:43-56. [PMID: 30209600 DOI: 10.1007/s00520-018-4456-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Resilience is a dynamic process of positive adaptation to adversity, including cancer. While the term is used frequently by researchers, controversy exists over its conceptualisation and little is known if and how cancer patients use the term resilience. We examined qualitative studies exploring cancer patient experiences/perceptions of resilience to understand: (a) definitions of resilience as identified by patients and researchers and (b) the themes relating to attributes of resilience as identified by patients. METHODS Four electronic databases (MEDLINE, PsycINFO, SCOPUS, and CINAHL) were searched from database inception to November 2017, identifying qualitative studies of adult cancer patients/survivors which included resilience and cancer in the title, abstract, or medical subject headings. Articles were excluded if resilience was not a theme or outcome or was discussed primarily in the context of non-individuals. Thematic analysis was used to code studies and generate analytical themes, and a single author identified definitions of resilience within the studies. RESULTS Five hundred and seventy-three non-duplicate citations were screened, resulting in 65 citations screened for full-text review. Of these, 33 were excluded, leaving 32 studies. Four thematic categories emerged; coping strategies, social support, spirituality, and growth, within which 79 individual themes were identified. Eight researcher definitions and no patient definitions of resilience were identified. CONCLUSION This review found no cancer patient definitions of resilience and that cancer patients are seldom quoted using the term resilience directly, instead identifying coping strategies, social support, growth, and spirituality as attributes associated with resilience.
Collapse
|
8
|
Foote FO, Benson H, Berger A, Berman B, DeLeo J, Deuster PA, Lary DJ, Silverman MN, Sternberg EM. Advanced Metrics for Assessing Holistic Care: The "Epidaurus 2" Project. Glob Adv Health Med 2018; 7:2164957X18755981. [PMID: 29497586 PMCID: PMC5824899 DOI: 10.1177/2164957x18755981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/08/2017] [Indexed: 11/16/2022] Open
Abstract
In response to the challenge of military traumatic brain injury and posttraumatic stress disorder, the US military developed a wide range of holistic care modalities at the new Walter Reed National Military Medical Center, Bethesda, MD, from 2001 to 2017, guided by civilian expert consultation via the Epidaurus Project. These projects spanned a range from healing buildings to wellness initiatives and healing through nature, spirituality, and the arts. The next challenge was to develop whole-body metrics to guide the use of these therapies in clinical care. Under the "Epidaurus 2" Project, a national search produced 5 advanced metrics for measuring whole-body therapeutic effects: genomics, integrated stress biomarkers, language analysis, machine learning, and "Star Glyphs." This article describes the metrics, their current use in guiding holistic care at Walter Reed, and their potential for operationalizing personalized care, patient self-management, and the improvement of public health. Development of these metrics allows the scientific integration of holistic therapies with organ-system-based care, expanding the powers of medicine.
Collapse
Affiliation(s)
| | - Herbert Benson
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Ann Berger
- National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Brian Berman
- The Institute for Integrative Health, Baltimore, Maryland
- University of Maryland School of Medicine Center for Integrative Medicine, Baltimore, Maryland
| | - James DeLeo
- The NIH Clinical Center Department of Clinical Research Informatics, Bethesda, Maryland
| | | | - David J Lary
- The University of Texas at Dallas, Richardson, Texas
| | - Marni N. Silverman
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | |
Collapse
|
9
|
Grattan K, Kubrak C, Caine V, O’Connell DA, Olson K. Experiences of Head and Neck Cancer Patients in Middle Adulthood: Consequences and Coping. Glob Qual Nurs Res 2018; 5:2333393618760337. [PMID: 29568793 PMCID: PMC5858616 DOI: 10.1177/2333393618760337] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/11/2018] [Accepted: 01/17/2018] [Indexed: 12/19/2022] Open
Abstract
The head and neck cancer (HNC) rate is rising among the middle-aged adult population. This trend has been attributed primarily to human papillomavirus exposure. An HNC diagnosis and its complex treatments may trigger life-changing physical, emotional, and social consequences. An interpretive descriptive study was conducted to describe the experiences of a purposive sample of 10 middle-aged adults who had experienced HNC. Two main themes were identified: consequences of HNC and coping with HNC. Subthemes of consequences of HNC included: voicelessness; being or looking sick; shifts in family dynamics; and sexual practices, sexual feelings, and stigma. Subthemes of coping with HNC included seeking information, discovering inner strengths, relying on a support network, establishing a sense of normalcy, and finding meaning within the experience. Supportive nursing interventions were identified by considering results from the standpoint of King's theory of goal attainment.
Collapse
Affiliation(s)
- Kathryn Grattan
- University of Alberta, Edmonton, Alberta, Canada
- St. Joseph’s Health Care, London, Ontario, Canada
| | | | - Vera Caine
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Karin Olson
- University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
10
|
ELIAS ACA, RICCI MD, RODRIGUEZ LHD, PINTO SD, GIGLIO JS, BARACAT EC. Development of a Brief Psychotherapy modality entitled RIME in a hospital setting using alchemical images. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2017. [DOI: 10.1590/1982-02752017000400009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This article refers to the development of a Brief Psychotherapy modality in a hospital setting through the use of alchemical images. This Intervention, entitled RIME (Relaxamento, Imagens Mentais, Espiritualidade) (RIME Intervention ‒ Relaxation, Mental Images, Spirituality), has been developed for 17 years. This article presents the fourth and last stage of this process, which refers to the application of RIME in women undergoing treatment for breast cancer with the possibility of a cure. The main theoretical frameworks used were Analytical Psychology and Near Death Experiences. This is a comparative exploratory and descriptive research that uses the quantitative and qualitative approaches. The main focus of this article is to present the qualitative results. Qualitative data were collected using recorded semi-structured interviews and graphical representations, prior to the 1st and after the 3rd RIME sessions. In summary, the results obtained showed that the RIME Intervention promoted empowerment for libido strengthening, as a constructive force, in women with breast cancer with the possibility of a cure.
Collapse
Affiliation(s)
| | | | | | - Stela Duarte PINTO
- Instituto do Câncer do Estado de São Paulo Otávio Frias de Oliveira, Brasil
| | | | | |
Collapse
|
11
|
Coats H, Rosenfeld AG, Crist JD, Sternberg E, Berger A. Using cognitive interviews to improve a Psychological-Social-Spiritual Healing instrument: Voices of aging African Americans with serious illness. Appl Nurs Res 2017; 39:109-114. [PMID: 29422143 DOI: 10.1016/j.apnr.2017.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/17/2017] [Accepted: 11/02/2017] [Indexed: 11/17/2022]
Abstract
AIM The purpose of this study was to contribute to content validity, by providing input into the linguistic and pragmatic validities, of a 53 item Psychological-Social-Spiritual Healing instrument. BACKGROUND Discovery of cultural values and beliefs from African American elders' experiences of illness provides insight for development of more culturally sensitive instruments. METHODS Through an exploratory descriptive design, this study used cognitive interviewing methods to examine linguistic and pragmatic validity of the Psychological-Social-Spiritual Healing instrument, from the perspectives of aging seriously ill AAs. Participants were recruited from urban Jackson, MS from community settings from October 2014 to January 2015. With a purposefully chosen sample of seriously ill African Americans elders (N=15), and using the method of cognitive interviewing, responses related to cultural relevance, clarity and meaning of the 53 items of the instrument were collected. This in-depth query of items was accomplished through the use of both verbal probing and think aloud methods of cognitive interviewing. RESULTS Thirty-seven items were retained. Eight items were revised. Eight items were deleted. CONCLUSIONS From the expert input of seriously ill African American elders, a systematic decision-making process of item retention, revision or deletion led to the development of a more culturally sensitive Psychological-Social-Spiritual Healing instrument.
Collapse
Affiliation(s)
- Heather Coats
- University of Colorado, Anschutz Medical Campus, College of Nursing, 13120 E. 19th Avenue Aurora, CO 80045, United States.
| | - Anne G Rosenfeld
- The University of Arizona, College of Nursing, 1305 N. Martin Avenue, Tucson, AZ 85721-0203, United States.
| | - Janice D Crist
- The University of Arizona, College of Nursing, 1305 N. Martin Avenue, Tucson, AZ 85721-0203, United States.
| | - Esther Sternberg
- University of Arizona, College of Medicine, P.O. Box 245153, Tucson, AZ 85724-5153, United States.
| | - Ann Berger
- NIH Clinical Center, 10 Center Dr, Bethesda, MD 20814, United States.
| |
Collapse
|
12
|
Cheng MJ, Smith BD, Hourigan CS, Gojo I, Pratz KW, Blackford AL, Mehta AK, Smith TJ. A Single Center Survey of Health-Related Quality of Life among Acute Myeloid Leukemia Survivors in First Complete Remission. J Palliat Med 2017; 20:1267-1273. [PMID: 28537498 DOI: 10.1089/jpm.2017.0069] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) is one of the most common types of leukemia in adults, but there is limited information on survivors' quality of life (QOL) after remission. OBJECTIVE We piloted a survey exploring patient-reported outcomes for people with AML in first complete remission (CR1) to determine whether patients felt the survey is relevant to their well-being and to summarize patient characteristics. DESIGN/MEASUREMENTS Cross-sectional survey of a convenience sample of AML patients in CR1 assessing QOL and functioning (European Organization for Research and Treatment of Cancer [EORTC] QLQ-C30 v 3.0), well-being (QOL-cancer survivor [QOL-CS]), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-Fatigue]), and anxiety and depression (hospital anxiety and depression scale [HADS]). The survey contained five open-ended questions. RESULTS Eighteen patients completed the survey. Most felt it was completely or mostly relevant (88.8%) in describing their QOL. Participants scored well on the EORTC QLQ-C30, fatigue being the most common symptom (83%).The FACIT-Fatigue mean score was 28.7 and median score was 33.5 (normal ≥30). Two scored in the abnormal range for anxiety and one for depression on the HADS. On the QOL-CS, participants scored more than 6 out of 10 in most domains, except the subscales of distress and fear. CONCLUSIONS The survey content and length were appropriate. Patients reported ongoing fatigue, fears of future test results, getting a second cancer, and recurrence of cancer. Survivors experience ongoing symptoms, highlighting the importance of providers performing ongoing symptom and needs assessments.
Collapse
Affiliation(s)
- M Jennifer Cheng
- 1 Pain and Palliative Care Service, Clinical Center, National Institutes of Health , Bethesda, Maryland
| | - B Douglas Smith
- 2 Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| | - Christopher S Hourigan
- 3 Myeloid Malignancies Section, Hematology Branch, National Heart, Lung and Blood Institute , Baltimore, Maryland
| | - Ivana Gojo
- 2 Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| | - Keith W Pratz
- 2 Division of Hematologic Malignancies, Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| | - Amanda L Blackford
- 4 Division of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University , Baltimore, Maryland
| | - Ambereen K Mehta
- 1 Pain and Palliative Care Service, Clinical Center, National Institutes of Health , Bethesda, Maryland
| | - Thomas J Smith
- 5 Program in Palliative Medicine and Department of Medical Oncology, Sidney Kimmel Comprehensive Cancer Center at the Johns Hopkins Hospital , Baltimore, Maryland
| |
Collapse
|
13
|
Coats HL. African American elders' psychological-social-spiritual cultural experiences across serious illness: an integrative literature review through a palliative care lens. ANNALS OF PALLIATIVE MEDICINE 2017; 6:253-269. [PMID: 28595425 DOI: 10.21037/apm.2017.03.09] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/10/2016] [Indexed: 01/11/2023]
Abstract
Disparities in palliative care for seriously ill African American elders exist because of gaps in knowledge around culturally sensitive psychological, social, and spiritual care. The purpose of this integrative literature review is to summarize the research examining African American elders' psychological, social, and spiritual illness experiences. Of 108 articles, 60 quantitative, 42 qualitative, and 6 mixed methods studies were reviewed. Negative and positive psychological, social, and spiritual experiences were noted. These experiences impacted both the African American elders' quality of life and satisfaction with care. Due to the gaps noted around psychological, social, and spiritual healing and suffering for African American elders, palliative care science should continue exploration of seriously ill African American elders' psychological, social, and spiritual care needs.
Collapse
Affiliation(s)
- Heather Lea Coats
- UW/Cambia Palliative Care Center of Excellence, University of Washington, USA.
| |
Collapse
|
14
|
Coats H, Crist JD, Berger A, Sternberg E, Rosenfeld AG. African American Elders' Serious Illness Experiences: Narratives of "God Did," "God Will," and "Life Is Better". QUALITATIVE HEALTH RESEARCH 2017; 27:634-648. [PMID: 26701962 PMCID: PMC5717513 DOI: 10.1177/1049732315620153] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The foundation of culturally sensitive patient-centered palliative care is formed from one's social, spiritual, psychological, and physical experiences of serious illness. The purpose of this study was to describe categories and patterns of psychological, social, and spiritual healing from the perspectives of aging seriously ill African American (AA) elders. Using narrative analysis methodology, 13 open-ended interviews were collected. Three main patterns were "prior experiences," "I changed," and "across past, present experiences and future expectations." Themes were categorized within each pattern: been through it . . . made me strong, I thought about . . . others, went down little hills . . . got me down, I grew stronger, changed priorities, do things I never would have done, quit doing, God did and will take care of me, close-knit relationships, and life is better. "Faith" in God helped the aging seriously ill AA elders "overcome things," whether their current illness or other life difficulties.
Collapse
Affiliation(s)
| | | | - Ann Berger
- National Institute of Health Clinical Center, Bethesda, Maryland, USA
| | | | | |
Collapse
|
15
|
Sloan DH, BrintzenhofeSzoc K, Kichline T, Baker K, Pinzon JP, Tafe C, Li L, Cheng MJ, Berger A. An assessment of meaning in life-threatening illness: development of the Healing Experience in All Life Stressors (HEALS). PATIENT-RELATED OUTCOME MEASURES 2017; 8:15-21. [PMID: 28243158 PMCID: PMC5317311 DOI: 10.2147/prom.s118696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Context Patients with life-threatening or chronic illness report an experience of increased positive psychological, social, and/or spiritual change during diagnosis and/or treatment of their illness, even in the face of unfavorable prognosis. This transformation begins through the ability to make their life meaningful by forming meaningful connections that emerge through self-introspection and relationships with a divine entity, nature, and other people. The Healing Experience in All Life Stressors (HEALS) assessment provides a way to identify distress-causing changes that may interfere with the development of meaning and psycho–social–spiritual homeostasis. Objective Preliminary examination of responses to items on the HEALS and examination of the factor structure. Method The 48-item HEALS questionnaire was developed using a multistep process: literature review for concept development, item generation from qualitative data, and face and content validity by expert panel. In the current study, HEALS was completed by 100 patients diagnosed with life-limiting disease and seen by the palliative care team at a large research institution in the US. Exploratory factor analysis techniques were used to determine scale structure of the instrument. Results Outcome testing of sample adequacy using Kaiser–Meyer–Olkin statistic was 0.75, which exceeds the recommended value of 0.60. The HEALS show very good internal consistency with a Cronbach’s a of 0.94. Overall results of the exploratory factor analysis established a four-factor questionnaire: 1) religion; 2) spirituality, demonstrated by a) interaction with a religious community and b) belief in higher power; 3) intrapersonal; and 4) interpersonal relationships expressed through psychological changes resulting in enhanced outlook and improvement in relationships with family and friends. Conclusion This study involved the initial step to commence the process of scale validation, with promising outcomes identifying subscales as an effective way to assess the construct of healing. These findings support further examination using cognitive appraisal and confirmatory factor analysis.
Collapse
Affiliation(s)
| | - Karlynn BrintzenhofeSzoc
- School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA
| | - Tiffany Kichline
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| | - Karen Baker
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| | - Jean-Paul Pinzon
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| | - Christina Tafe
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| | - Lingsheng Li
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| | - M Jennifer Cheng
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| | - Ann Berger
- Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD
| |
Collapse
|
16
|
Increased Incidence of Fatigue in Patients with Primary Immunodeficiency Disorders: Prevalence and Associations Within the US Immunodeficiency Network Registry. J Clin Immunol 2017; 37:153-165. [PMID: 28124237 DOI: 10.1007/s10875-016-0367-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/20/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Patients with primary immunodeficiency (PID) often report fatigue, yet this symptom has not been studied in PID. Fatigue affects 6-7.5% of healthy adults. The goal of this study is to estimate the prevalence of fatigue in patients with PID and investigate its associated factors. METHODS We analyzed 2537 PID patients registered in USIDNET to determine responses to the field "fatigue" in the core registry form. Demographics, immune phenotypes, and comorbid conditions were compared between fatigued and non-fatigued patients to identify relevant associations and potential drivers. A focused analysis was performed for patients with predominantly antibody deficiency disorders (PADs). RESULTS Fatigue was reported in 25.9% (95% CI 23.7-28.3) of PAD patients, compared to 6.4% (95% CI 4.9-8.2) of non-PAD. Patients with common variable immunodeficiency (CVID) had the highest prevalence of fatigue (p < 0.001) among all PID diagnoses. Other factors that were associated with a higher rate of fatigue among PAD patients included female sex, higher BMI, depression, bronchiectasis, and autoimmunity. Additionally, fatigued PAD patients had lower absolute lymphocyte, CD3, CD4, and CD8 counts compared to non-fatigued patients. CONCLUSION Our findings suggest that fatigue is overrepresented in PAD patients. Prospective studies to estimate prevalence, risk factors, and fatigue etiology in PID are warranted, so therapeutic interventions can be considered.
Collapse
|
17
|
Lin KY, Frawley H, Denehy L, Feil D, Granger C. Exercise interventions for patients with gynaecological cancer: a systematic review and meta-analysis. Physiotherapy 2016; 102:309-319. [DOI: 10.1016/j.physio.2016.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 02/16/2016] [Indexed: 02/09/2023]
|
18
|
Mardani-Hamooleh M, Heidari H. Cancer patients' effort to return to normal life: a hermeneutic study. Scand J Caring Sci 2016; 31:351-358. [DOI: 10.1111/scs.12354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/19/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Marjan Mardani-Hamooleh
- School of Nursing and Midwifery; Department of Nursing; Iran University of Medical Sciences; Tehran Iran
| | - Haydeh Heidari
- Faculty of Nursing and Midwifery; Modeling in Health Research Center; Shahrekord University of Medical Sciences; Shahrekord Iran
| |
Collapse
|
19
|
Nadarajah SR, Buchholz SW, Wiegand DL, Berger A. The lived experience of individuals in cardiac rehabilitation who have a positive outlook on their cardiac recovery: A phenomenological inquiry. Eur J Cardiovasc Nurs 2016; 16:230-239. [DOI: 10.1177/1474515116651977] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Susan W Buchholz
- Adult Health and Gerontological Nursing, Rush University College of Nursing, USA
| | - Debra L Wiegand
- Department of Organizational Systems and Adult Health, University of Maryland, Baltimore, USA
| | - Ann Berger
- Pain and Palliative Care, Clinical Center, National Institutes of Health, USA
| |
Collapse
|
20
|
Berger A. "Mother MD Intense": The Need for Intentional Healing. J Pain Symptom Manage 2016; 52:151-3. [PMID: 27256617 DOI: 10.1016/j.jpainsymman.2016.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 05/20/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Ann Berger
- National Institutes of Health, Clinical Center, Bethesda, Maryland, USA.
| |
Collapse
|
21
|
Kessler TA. Journey of a Woman With Terminal Cervical Cancer. Clin J Oncol Nurs 2016; 20:340-2. [PMID: 27206304 DOI: 10.1188/16.cjon.340-342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
When a cervical cancer diagnosis is made during a terminal stage, a woman is faced with many challenges. Although a terminal illness has many negative effects, such as physical pain, scarring, fear, and sexual dysfunction, women may experience a positive impact on their life, such as improved well-being and a greater appreciation of daily life. The individual experience can lead to personal revelations. Sometimes, the diagnosis can even be seen as a blessing. Understanding a personal experience in a real-life context of the terminal stages of disease is important. This story shares the day-to-day journey of a woman living with a terminal illness of cervical cancer.
Collapse
|
22
|
Abstract
AbstractObjective:The goal of this pilot study was to identify the processes by which healing occurs in patients who experience a life-threatening illness.Method:Healing was examined by using two qualitative studies that employed a semistructured interview process (interviews lasted between 30 and 115 minutes). There were 10 cardiac event survivors and 9 cancer survivors. These participants came from a community hospital setting (cardiac), nonmedical holistic services organization (cancer), and a research hospital (cancer). Before participants could take part in the study, they were administered preliminary screening measurements, the first of which was an instrument similar to the Distress Thermometer. Participants then self-reported their positive life-transforming changes. If one to three changes were reported six months after onset of the illness, participants were deemed to have passed the screening. Finally, participants were tested for speaking volume and clarity.Results:An overall theme that was prevalent throughout the interviews was medical support. Participants found that their positive, life-transforming changes were typically connected with supportive caregivers who helped to create a culture of care. They also indicated that an absence of this medical supportive care hindered development of such life-transforming changes.Significance of Results:Our results indicate that a medical care team will be more effective if a positive culture of care is created. This can be implemented if the team provides comfort, which involves being more engaged in the treatment of patients as well as being more attentive to their psychosocial needs.
Collapse
|
23
|
Polley MJ, Jolliffe R, Boxell E, Zollman C, Jackson S, Seers H. Using a Whole Person Approach to Support People With Cancer: A Longitudinal, Mixed-Methods Service Evaluation. Integr Cancer Ther 2016; 15:435-445. [PMID: 27060342 PMCID: PMC5739159 DOI: 10.1177/1534735416632060] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 12/23/2015] [Accepted: 01/14/2016] [Indexed: 12/29/2022] Open
Abstract
Introduction. Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this article is to (a) evaluate short- and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC) and (b) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods. Longitudinal mixed-methods service evaluation (n = 135). Data collected included health-related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity–MYCaW); lifestyle behavior (bespoke questionnaire), and participants’ experiences over 12 months postcourse. Results. Statistically and clinically significant improvements from baseline to 12 months in severity of MYCaW Concerns (n = 64; P < .000) and mean total HRQoL (n = 66; P < .000). The majority of MYCaW concerns were “psychological and emotional” and about participants’ well-being. Spiritual, emotional, and functional well-being contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. Three to 6 months postcourse was identified as the time when more support was most likely to be needed. Conclusions. Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behavior change were also identified. These data then informed wider and more person-centered clinical provision to increase the maintenance of positive long-term behavior changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.
Collapse
|
24
|
|
25
|
Komatsu H, Yagasaki K, Yamauchi H, Yamauchi T. Patients’ Perspectives on Creating a Personal Safety Net During Chemotherapy. Clin J Oncol Nurs 2016; 20:13-6. [DOI: 10.1188/16.cjon.13-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
26
|
Knowles LM, Skeath P, Jia M, Najafi B, Thayer J, Sternberg EM. New and Future Directions in Integrative Medicine Research Methods with a Focus on Aging Populations: A Review. Gerontology 2015; 62:467-76. [DOI: 10.1159/000441494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 10/06/2015] [Indexed: 11/19/2022] Open
Abstract
This review discusses existing and developing state-of-the-art noninvasive methods for quantifying the effects of integrative medicine (IM) in aging populations. The medical conditions of elderly patients are often more complex than those of younger adults, making the multifaceted approach of IM particularly suitable for aging populations. However, because IM interventions are multidimensional, it has been difficult to examine their effectiveness and mechanisms of action. Optimal assessment of IM intervention effects in the elderly should include a multifaceted approach, utilizing advanced analytic methods to integrate psychological, behavioral, physiological, and biomolecular measures of a patient's response to IM treatment. Research is presented describing methods for collecting and analyzing psychological data; wearable unobtrusive devices for monitoring heart rate variability, activity and other behavioral responses in real time; immunochemical methods for noninvasive molecular biomarker analysis, and considerations and analytical approaches for the integration of these measures. The combination of methods and devices presented in this review will provide new approaches for evaluating the effects of IM interventions in real-life ambulatory settings of older adults, and will extend the concept of mobile health to the domains of IM and healthy aging.
Collapse
|
27
|
Elias ACA, Ricci MD, Rodriguez LHD, Pinto SD, Giglio JS, Baracat EC. The biopsychosocial spiritual model applied to the treatment of women with breast cancer, through RIME intervention (relaxation, mental images, spirituality). Complement Ther Clin Pract 2015; 21:1-6. [PMID: 25682524 DOI: 10.1016/j.ctcp.2015.01.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 01/20/2015] [Indexed: 10/24/2022]
Abstract
This postdoctoral study on the application of the RIME intervention in women that had undergone mastectomy and were in treatment, aimed to promote psychospiritual and social transformations to improve the quality of life, self-esteem and hope. A total of 28 women participated and were randomized into two groups. Brief Psychotherapy (PB) (average of six sessions) was administered in the Control Group, and RIME (three sessions) and BP (average of five sessions) were applied in the RIME Group. The quantitative results indicated a significant improvement (38.3%) in the Perception of Quality of Life after RIME according to the WHOQOL, compared both to the BP of the Control Group (12.5%), and the BP of the RIME Group (16.2%). There was a significant improvement in Self-esteem (Rosenberg) after RIME (14.6%) compared to the BP of the Control Group (worsened 35.9%), and the BP of the RIME Group (8.3%). The improvement in well-being, considering the focus worked on (Visual Analog Scale), was significant in the RIME Group (bad to good), as well as in the Control Group (unpleasant to good). The qualitative results indicated that RIME promotes creative transformations in the intrapsychic and interpersonal dimensions, so that new meanings and/or new attitudes emerge into the consciousness. It was observed that RIME has more strength of psychic structure, ego strengthening and provides a faster transformation that BP, therefore it can be indicated for crisis treatment in the hospital environment.
Collapse
Affiliation(s)
- Ana Catarina Araújo Elias
- Department of Obstetrics and Gynecology of the Faculty of Medicine, University of São Paulo (FMUSP), Brazil; Institute of Cancer of the State of São Paulo (ICESP), Brazil.
| | - Marcos Desidério Ricci
- Department of Obstetrics and Gynecology of the Faculty of Medicine, University of São Paulo (FMUSP), Brazil; Institute of Cancer of the State of São Paulo (ICESP), Brazil
| | | | | | - Joel Sales Giglio
- Department of Medical Psychology and Psychiatry of the Faculty of Medical Sciences, State University of Campinas (FCM UNICAMP), Brazil; Jungian Association of Brazil (AJB) Linked to the International Association for Analytical Psychology (IAAP)), Brazil
| | - Edmund Chada Baracat
- Department of Obstetrics and Gynecology of the Faculty of Medicine, University of São Paulo (FMUSP), Brazil; Institute of Cancer of the State of São Paulo (ICESP), Brazil
| |
Collapse
|
28
|
Psychosocial experiences in the context of life-threatening illness: The cardiac rehabilitation patient. Palliat Support Care 2014; 13:749-56. [DOI: 10.1017/s1478951514000583] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:One of the most prevalent life-threatening illnesses is heart disease. The initial trauma of being diagnosed with a life-threatening illness or having a cardiac event can begin a psychosocial chain reaction that results in a transformation of the lives of these patients. The goal of our study was to investigate the lived experiences of psychosocial healing in rehabilitation of cardiac patients using a qualitative written interview.Method:A purposive sample of 14 cardiac event survivors was recruited. Participants were interviewed after informed consent and screening. We used a qualitative analysis and model-revision approach similar to the procedure outlined by Charmaz (2006).Results:Participants consistently mentioned that a heightened awareness of mortality was a motivating factor that led to participants focusing more on their family and relationships, having an enhanced outlook on life, and making healthy lifestyle changes.Significance of results:If clinicians are able to employ a measure to better understand the nature of a patient's progression from cardiac event to successful recovery, interventions such as cardiac rehabilitation can be implemented earlier and more effectively during the course of the illness and recovery phases of treatment. Theoretically, this early detection of a patient's progression could reduce the time spent recovering from a cardiac event, and it would allow treatments for these conditions to better alleviate the psychosocial concerns faced by patients.
Collapse
|
29
|
Spirituality in the context of life-threatening illness and life-transforming change. Palliat Support Care 2014; 13:653-60. [DOI: 10.1017/s1478951514000340] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:Individuals with life-threatening illness often engage in some form of spirituality to meet increased needs for meaning and purpose. This study aimed to identify the role of spirituality in persons who had reported positive, life-transforming change in relation to life-threatening cancer or cardiac events, and to connect these roles to palliative and supportive care.Method:A purposive sample of 10 cardiac survivors and 9 cancer survivors was recruited. Once the participants had given informed consent and passed screening in relation to life-transforming change and distress, they engaged in a semistructured one-hour qualitative interview on the theme of how their life-transforming change occurred in the context of their life-threatening illness. In the present article, our phenomenological analysis focuses on participants' references to purpose and meaning in their lives, with particular attention to the role and context of participants' spirituality.Results:Participants mentioned spirituality, meaning, and purpose in many contexts, including connecting with family and friends, nature, art, music, and sometimes creating a relationship with God. Participants often accessed spirituality by enhancing connections in their own lives: with a higher power, people, their work, or themselves. These enhanced connections gave participants greater meaning and purpose in their lives, and substantially helped participants to adjust to their life-threatening illnesses.Significance of results:Understanding the roles and contexts of spirituality among patients with a life-threatening illness allows us to develop better palliative and supportive care plans. Spiritually oriented supportive care may include support groups, yoga, meditation, nature, music, prayer, or referral to spiritual or religious counselors. A quantitative scale is needed to help healthcare clinicians assess the spiritual and coping needs of individuals with life-threatening illness.
Collapse
|
30
|
Schumacher A, Sauerland C, Silling G, Berdel WE, Stelljes M. Resilience in patients after allogeneic stem cell transplantation. Support Care Cancer 2013; 22:487-93. [PMID: 24101151 DOI: 10.1007/s00520-013-2001-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 09/23/2013] [Indexed: 01/18/2023]
Abstract
PURPOSE After undergoing allogeneic stem cell transplantation (alloSCT), patients adapt in very different ways to their taxing situation. Some patients cope very well; others almost seem to fail. Psychosocial variables are important factors for successful reintegration. Besides quality of life, resilience may help to understand the variance in individual differences in adaptation after alloSCT. METHODS A pilot study at the University Hospital Muenster, Germany, assessed resilience in patients after alloSCT. The sample included 75 patients (leukemia, lymphoma, myeloma, aplastic anemia) aged 20-76 years. The instruments Resilience Scale RS-25, Hospital Anxiety and Depression Scale, General Self-efficacy Scale, and EORTC QLQ-C30 were used. RESULTS Resilience is positively correlated with quality of life (Spearman's rho 0.587) and social functioning (0.472), negatively with anxiety (-0.491) and depression (-0.577). Dividing the sample at the median resilience score of 144 reveals that high-resilience patients report less anxiety (p = 0.008) and depression (p < 0.001); higher physical (p = 0.041), emotional (p = 0.030), and social functioning (p = 0.003); and a better quality of life (p < 0.001) than low-resilience patients. No effects on resilience were found for age, gender, and primary disease entity. The high correlation of resilience and self-efficacy (r = 0.698) shows the strong relationship between the two concepts. Our results indicate a potential influence of the time span from alloSCT on patients' resilience. CONCLUSIONS Resilience should be considered as a protective psychosocial factor for patients after alloSCT. A high degree of resilience can help patients to adapt to their situation and to resume their everyday life.
Collapse
Affiliation(s)
- Andrea Schumacher
- Department of Medicine A/Hematology and Oncology, University of Muenster, Albert-Schweitzer-Campus 1, Bldg. A 1, 48149, Muenster, Germany,
| | | | | | | | | |
Collapse
|