DOCSLIB.ORG

Evaluation of the Effects of a Psychosocial Intervention on Mood, Coping and Quality of Life in Cancer Patients

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Evaluation of the Effects of a Psychosocial Intervention on Mood, Coping and Quality of Life in Cancer Patients Evaluation of the effects of a psychosocial intervention on mood, coping and quality of life in cancer patients Nicola Reavley BSc (Hons) Pharmacology Bristol University, UK Submitted in fulfilment of the requirements for the Doctor of Philosophy, Faculty of Life and Social Sciences, Swinburne University of Technology 2006 Acknowledgements Many people have provided me with very valuable assistance, guidance and support during the time taken to do this research. I wish to thank my supervisors, particularly Professor Avni Sali, without whom I would not have started and Dr Julie Pallant without whom I would not have finished. Professor Sali’s vision, encouragement and positive attitude have been an inspiration, and Dr Pallant’s support, clarity and attention to detail have been invaluable. My thanks go to Dr Ian Gawler and Dr Ruth Gawler for generously giving of their time and guidance to enable me to research the work they do. I would also like to thank the staff at The Gawler Foundation, Professor John Patterson, Dr Craig Hassed, Dr Luis Vitetta and Pauline McKinnon. And last but not least, I owe my thanks to the people that gave up their time to complete the questionnaires. Many of these were cancer patients and their courage and positive attitude in the face of difficult circumstances were unfailingly inspiring. Declaration This thesis contains no material which has been accepted for the award of any other degree or diploma in any University of other institution. To the best of my knowledge this thesis contains no material previously published or written by another person except where due reference is made in the text of the thesis. Nicola Reavley Table of Contents Table of Contents i List of Tables xi List of Figures xix List of Appendices xxii Abstract xxiii CHAPTER ONE: INTRODUCTION AND LITERATURE REVIEW 1.1 Overview of the thesis ............................................................................................................. 1 1.2 Introduction to the literature review..................................................................................... 2 1.3 Cancer ...................................................................................................................................... 3 1.3.1 Epidemiology of cancer in Australia........................................................................................ 4 1.3.2 Risk factors for cancer ............................................................................................................. 5 1.3.3 Psychosocial factors and cancer incidence............................................................................... 6 1.3.4 Diagnosis and management of cancer...................................................................................... 6 1.3.4.1 Conventional medical treatment .......................................................................................... 7 1.3.4.1.1 Supportive care........................................................................................................... 9 1.3.4.1.1.1 Pain and other symptoms....................................................................................9 1.3.4.1.1.2 Management of adverse effects of treatment.................................................... 10 1.3.4.2 Care of the dying patient.................................................................................................... 10 1.4 Adjustment to cancer............................................................................................................ 11 1.4.1 Cancer and emotional distress................................................................................................ 12 1.4.1.1 Adjustment disorders and cancer ....................................................................................... 13 1.4.1.2 Depression and cancer ....................................................................................................... 13 1.4.1.3 Anxiety disorders and cancer............................................................................................. 15 1.4.2 Pattern of distress over time................................................................................................... 15 1.4.2.1 Diagnosis ........................................................................................................................... 16 1.4.2.2 Acute survival.................................................................................................................... 17 1.4.2.3 Extended survival .............................................................................................................. 18 1.4.2.4 Permanent survival ............................................................................................................ 18 1.4.2.4.1 Survival and positive psychological consequences .................................................. 19 1.4.3 Recurrence ............................................................................................................................. 20 1.4.4 Transition to palliative care.................................................................................................... 20 1.4.5 Quality of life......................................................................................................................... 20 1.4.5.1 Definition of QOL ............................................................................................................. 21 1.4.5.2 QOL assessment ................................................................................................................ 22 1.4.5.3 QOL and prognosis............................................................................................................ 24 1.4.6 Factors influencing adjustment to cancer............................................................................... 24 1.4.6.1 Disease variables and adjustment ...................................................................................... 24 1.4.6.2 Demographic variables and adjustment ............................................................................. 25 1.4.6.3 Health behaviours and adjustment ..................................................................................... 26 1.5 Psychosocial factors and adjustment to cancer .................................................................. 27 1.5.1 Coping with cancer ................................................................................................................ 27 1.5.1.1 Types of coping strategies ................................................................................................. 28 1.5.2 Coping and adjustment........................................................................................................... 29 1.5.2.1 Fighting spirit and helplessness ......................................................................................... 30 1.5.2.2 Avoidance/denial ............................................................................................................... 31 1.5.2.3 Variation in coping over time ............................................................................................ 32 1.5.2.4 Disease severity and coping............................................................................................... 33 1.5.3 Coping style and disease progression..................................................................................... 34 1.5.4 Psychosocial stress and disease progression .......................................................................... 35 1.5.5 Spirituality/religion and adjustment to cancer........................................................................ 36 1.5.5.1 Definition of terms............................................................................................................. 36 1.5.6 Religion /spirituality and wellbeing in cancer patients .......................................................... 37 1.5.6.1 Coping ............................................................................................................................... 38 1.5.6.2 Negative and positive religious coping.............................................................................. 40 1.5.6.3 Spirituality/religiosity distinction ...................................................................................... 40 1.5.7 Social support and cancer....................................................................................................... 41 1.5.7.1 Types of social support...................................................................................................... 41 1.5.7.2 Social support and adjustment to cancer............................................................................ 42 1.5.7.2.1 Instrumental support.................................................................................................43 1.6 Psychosocial interventions in cancer care........................................................................... 44 1.6.1 Need for psychosocial support ............................................................................................... 44 1.6.2 Psychosocial interventions..................................................................................................... 45 1.6.2.1 Group interventions ........................................................................................................... 46 1.6.3 Psychosocial interventions and adjustment...........................................................................
Load more

Recommended publications
  • Cancer Forum
    Cancer Forum November 2005 Volume 29 Number 3 ISSN 0311-306X List of Contents Forum: Innovations in cancer imaging Overview Lourens Bester 139 Vascular access devices and the oncology patient Stuart Lyon 140 Magnetic resonance and oncology imaging Rathan Subramanian and Murali Guduguntla 144 Implantable peritoneal ports in the management of malignant ascites – technical innovation Lourens Bester 147 Vertebroplasty in oncology: a novel approach to pain relief in the cancer patient Glen Schlaphoff 148 Articles Medical Oncology Group of Australia, Pierre Fabre Cancer Achievement Award: Snake oil, coffee enemas and other famous nostrums for cancer – a recent history of cancer quackery in Australia Ray Lowenthal 150 The Cancer Council Australia’s Student Essay Competition: Cancer education for medical students: opportunities and challenges for the 21st Century Jennifer Anderson 154 Reports Australian behavioural research in cancer 158 Cancer Trials Database Victoria – first of its type in Australia 162 Cancer Institute NSW Standard Cancer Treatments (CI-SCaT) 163 News and announcements 165 Book reviews 168 Calendar of meetings 176 F ORUM Innovations in cancer imaging Overview Lourens Bester extensive list of references in his bibliography. Westmead Private Hospital & Westmead Public Hospital, The management of pain, once entirely the domain of a Sydney pain or anaesthetic specialist has also become part of the Email: [email protected] daily workload of the interventional radiologist. Clearly, the interventional radiologist is now a member of the multi- disciplinary oncological team. Glen Schlaphoff describes The burgeoning development of new computer applications ‘cementoplasty’ which is a procedure used for treating and increased funding from venture capitalists has lead bone pain in patients with metastatic bone disease.
    [Show full text]
  • The Importance of a Histological Diagnosis When Diagnosing and Treating Advanced Cancer. Famous Patient Recovery
    Haines and Lowenthal 1 Hypothesis. The importance of a histological diagnosis when diagnosing and treating advanced cancer.* Famous patient recovery may not have been from metastatic disease. Ian E Haines Ray M Lowenthal Correspondence: Dr Ian E Haines Melbourne Oncology Group Suite 45 Cabrini Medical Centre, Malvern 3144 Australia Ph: 03-9509-3744 Email: <[email protected]> This is an Accepted Article that has been peer-reviewed and approved for publication in the Internal Medicine Journal, but has yet to undergo copy- editing and proof correction. Please cite this article as an “Accepted Article”; doi: 10.1111/j.1445-5994.2011.02686.x Haines and Lowenthal 2 Over the last 33 years, mystery has surrounded the diagnosis and treatment of a very influential Australian patient. In the long gap between amputation of his leg for osteogenic sarcoma and successful treatment for widespread tuberculosis, he was told he had advanced and incurable metastatic sarcoma. Details of his recovery and the treatments used have been extensively described. An alternative hypothesis is advanced to explain his recovery. This hypothesis is advanced for two reasons. The first is to underline the modern recognition of the need to consider diagnostic investigations, including biopsy, before assigning the diagnosis of advanced cancer to any patient. This principle is especially vital in cases where two diseases can present in the same way. The second is that there a risk that if diseases are incorrectly labelled, incorrect treatments may be given. This can lead to misleading interpretations being made about non- traditional treatments providing “cures,” which can influence the decision-making of patients seeking answers and even lead them away from potentially curative traditional treatments.
    [Show full text]
  • Imj Haines and Lowenthal
    Internal Medicine Journal 42 (2012) PERSONAL VIEWPOINT Hypothesis. The importance of a histological diagnosis when diagnosing and treating advanced cancer. Famous patient recovery may not have been from metastatic diseaseimj_2686 212..216 I. E. Haines1,2 and R. M. Lowenthal3 1Medical Oncology, Cabrini Health, and 2Monash University Department of Medicine, Alfred Hospital, Melbourne, Victoria, and 3Department of Haematology/Oncology, Royal Hobart Hospital, Hobart, Tasmania, Australia Key words Abstract advanced and metastatic cancer, osteogenic sarcoma, accurate histological diagnosis, Over the past 33 years, mystery has surrounded the diagnosis and treatment of a very tuberculosis, choosing appropriate treatment. influential Australian patient. In the long gap between amputation of his leg for osteo- genic sarcoma and successful treatment for widespread tuberculosis, he was told he had Correspondence advanced and incurable metastatic sarcoma. Details of his recovery and the treatments Ian E. Haines, Melbourne Oncology Group, used have been extensively described. An alternative hypothesis is advanced to explain Cabrini Medical Centre, Suite 45, 183 his recovery. This hypothesis is advanced for two reasons. The first is to underline the Wattletree Rd., Malvern, Melbourne, Vic. 3144, modern recognition of the need to consider diagnostic investigations, including biopsy, Australia. before assigning the diagnosis of advanced cancer to any patient. This principle is E-mail: [email protected] especially vital in cases where two diseases can present in the same way. The second is that there a risk that if diseases are incorrectly labelled, incorrect treatments may be Received 27 April 2011; accepted 18 October given. This can lead to misleading interpretations being made about non-traditional 2011.
    [Show full text]
  • Las Vegas Lecture 1.Pub
    Hildenbrand G pg. 1 Practice of Gerson’s diet therapy in neoplastic diseases: A tissue-centric nutritional immunotherapy that anticipated Matzinger’s Danger Model with its tissue-based effector class control Gar Hildenbrand Dir Epidemiology - Gerson Research Organization Dir Research – Centro Hospitalario Internacional del Pacifico SA Lecture and PowerPoint presentation to the American Academy of Anti-Aging Medicine Fellowship in Integrative Cancer Therapy: Module II June 25, 2011 Las Vegas, Nevada Fellowship Dir: Mark Rosenberg, M.D. Hildenbrand G pg. 2 Gerson Research Organization 7807 Artesian Rd San Diego CA 92127 http://www.gerson-research.org garhildenbrand.com email: [email protected] Hildenbrand G pg. 3 Practice of Gerson’s diet therapy in neoplastic diseases: A tissue-centric nutritional immunotherapy that anticipated Matzinger’s Danger Model with its tissue-based effector class control Gar Hildenbrand Dir Epidemiology - Gerson Research Organization Dir Research – Centro Hospitalario Internacional del Pacifico SA Lecture and PowerPoint presentation to the American Academy of Anti-Aging Medicine Fellowship in Integrative Cancer Therapy: Module II June 25, 2011 Las Vegas, Nevada Fellowship Dir: Mark Rosenberg, M.D. Abstract Gerson labored alone at first, and later with extraordinary support, to develop a nutritional immunotherapeutic approach to tuberculosis. This disciplined clinical investigation led to some unconventional ways of conceiving of and monitoring the immune response of tissues per se, and manipulating them
    [Show full text]
  • Low Dose Naltrexone (LDN) Why Weren't You Told?
    Those Who Suffer Much Know Much about Low Dose Naltrexone (LDN) Why weren’t you told? aann oolldd ddrruugg aa ccoonnttrroovveerrssiiaall ttrreeaattmmeenntt bbeenneeffiittiinngg iimmmmuunnee ssyysstteemm ddiisseeaasseess tthhoouussaannddss aacchhiieevviinngg hheeaalltthh ssuucccceessss hhuunnddrreeddss ooff rreeccoorrddeedd ppaattiieenntt tteessttiimmoonniieess WWHHYY hhaavveenn’’tt yyoouu hheeaarrdd ooff iitt?? WWHHYY wwoonn’’tt yyoouu bbee ooffffeerreedd iitt?? In keeping with the altruism of contributors Case Health continues to offer this book to you FREE without charge or expectation You can 'share it forward' or host it on a website under the same philosophy without modification and free of charge in this fifth revision 51 Health Case Studies 19 health professional interviews & perspectives low dose naltrexone (LDN) in the beneficial treatment of immune system diseases Supporting evidence for the value of patient testimony to e-health systems worldwide Cris Kerr, Case Health 55 Webb Street, Brisbane, Queensland, Australia 4053 Advocating the value of patient testimony since May 2001 © Case Health 2006, revised July 2007, July 2008, July 2009, July 2010 (Original Websites: casehealth.com.au & casehealth.com May 2001 to May 2009) The case studies in this book feature Low Dose Naltrexone (LDN) an old drug a controversial treatment benefiting immune system diseases thousands achieving health success hundreds of recorded patient testimonies WHY haven’t you heard of it? WHY won’t you be offered it? of those conditions LDN has benefited the following are featured in this book Multiple Sclerosis HIV Hepatitis B & C Primary Lateral Sclerosis Cancer, Lymphoedema Fibromyalgia Crohn’s Disease Arthritis Parkinson’s Disease Relapsing Polychondritis (RPC) and diseases of immune system dysfunction Supporting data for this book has been assembled from untested patient testimony of health success.
    [Show full text]
  • Hypothesis. the Importance of a Histological Diagnosis When Diagnosing and Treating Advanced Cancer. Famous Patient Recovery
    Internal Medicine Journal 42 (2012) PERSONAL VIEWPOINT Hypothesis. The importance of a histological diagnosis when diagnosing and treating advanced cancer. Famous patient recovery may not have been from metastatic diseaseimj_2686 212..216 I. E. Haines1,2 and R. M. Lowenthal3 1Medical Oncology, Cabrini Health, and 2Monash University Department of Medicine, Alfred Hospital, Melbourne, Victoria, and 3Department of Haematology/Oncology, Royal Hobart Hospital, Hobart, Tasmania, Australia Key words Abstract advanced and metastatic cancer, osteogenic sarcoma, accurate histological diagnosis, Over the past 33 years, mystery has surrounded the diagnosis and treatment of a very tuberculosis, choosing appropriate treatment. influential Australian patient. In the long gap between amputation of his leg for osteo- genic sarcoma and successful treatment for widespread tuberculosis, he was told he had Correspondence advanced and incurable metastatic sarcoma. Details of his recovery and the treatments Ian E. Haines, Melbourne Oncology Group, used have been extensively described. An alternative hypothesis is advanced to explain Cabrini Medical Centre, Suite 45, 183 his recovery. This hypothesis is advanced for two reasons. The first is to underline the Wattletree Rd., Malvern, Melbourne, Vic. 3144, modern recognition of the need to consider diagnostic investigations, including biopsy, Australia. before assigning the diagnosis of advanced cancer to any patient. This principle is E-mail: [email protected] especially vital in cases where two diseases can present in the same way. The second is that there a risk that if diseases are incorrectly labelled, incorrect treatments may be Received 27 April 2011; accepted 18 October given. This can lead to misleading interpretations being made about non-traditional 2011.
    [Show full text]
  • The Medical Journal of Australia
    LETTERS Cancer patients at risk from correct sequence of events and relevant and meditation. Although diet and medita- inaccurate clinical reporting in inclusions, are outlined in Box 1. In sum- tion may be adjuncts to a patient’s well- a high-profile alternative mary, the major errors in the article were as being, it is unlikely in this case that they follows: were curative, and certainly veganism was treatment story: comments • Timeline errors. The authors stated that not a relevant factor. Immunotherapy with and corrections the patient first saw Dr Meares in Septem- BCG vaccine treatments, the timing of Grace O Gawler ber 1976, after chemotherapy had failed. In symptoms and the patient’s eventual diag- fact, the patient consulted Meares as a first- nosis of tuberculosis could be associated TO THE EDITOR: I would like to correct line treatment approach on 12 December with his remission, as postulated by his some inaccuracies in an article by Jelinek 1975, and did not consider chemothera- radiation oncologist in 1978.6 There is and Gawler in the December 2008 issue of peutic options until September 1976. The extensive scientific literature about remis- the TheJournal Medical about Journal a survivor of Australia of dissemi- ISSN: authors also stated that the patient had sion of cancer, including osteosarcoma, nated0025-729X osteosarcoma. 20 September1 2010 193 6 palliative radiotherapy in September 1976. associated with febrile conditions.5,8-15 The668-669 article describes a 58-year-old man In fact, the patient had only one course of The patient’s sporadic visits to doctors ©The Medical Journal of Australia who2010 was www.mja.com.audiagnosed in 1974, at the age of palliative radiotherapy treatment, in Febru- meant that metastases were not diagnosed 24 Lettersyears, with histologically confirmed ary 1976.
    [Show full text]
  • The Medical Journal of Australia
    LETTERS Cancer patients at risk from correct sequence of events and relevant and meditation. Although diet and medita- inaccurate clinical reporting in inclusions, are outlined in Box 1. In sum- tion may be adjuncts to a patient’s well- mary, the major errors in the article were as being, it is unlikely in this case that they a high-profile alternative follows: were curative, and certainly veganism was treatment story: comments • Timeline errors. The authors stated that not a relevant factor. Immunotherapy with and corrections the patient first saw Dr Meares in Septem- BCG vaccine treatments, the timing of Grace O Gawler ber 1976, after chemotherapy had failed. In symptoms and the patient’s eventual diag- fact, the patient consulted Meares as a first- nosis of tuberculosis could be associated TO THE EDITOR: I would like to correct line treatment approach on 12 December with his remission, as postulated by his some inaccuracies in an article by Jelinek 1975, and did not consider chemothera- radiation oncologist in 1978.6 There is and Gawler in the December 2008 issue of peutic options until September 1976. The extensive scientific literature about remis- the TheJournal Medical about Journal a survivor of Australia of dissemi- ISSN: authors also stated that the patient had sion of cancer, including osteosarcoma, nated0025-729X osteosarcoma. 20 September1 2010 193 6 palliative radiotherapy in September 1976. associated with febrile conditions.5,8-15 The668-669 article describes a 58-year-old man In fact, the patient had only one course of The patient’s sporadic visits to doctors ©The Medical Journal of Australia who2010 was www.mja.com.audiagnosed in 1974, at the age of palliative radiotherapy treatment, in Febru- meant that metastases were not diagnosed 24 Lettersyears, with histologically confirmed ary 1976.
    [Show full text]