The Existential Plight in Cancer: Significance of the First 100 Days

Weisman, Avery D.; Worden, J. William

doi:10.2190/uq2g-ugv1-3ppc-6387

Cited by 588 publications

(281 citation statements)

References 4 publications

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“…Self-esteem was measured with the Rosenberg selfesteem scale (Rosenberg, 1965) (Cronbach's alpha 0.81) and neuroticism with the neuroticism subscale of the Dutch Personality Inventory (Luteijn et al, 1975) (Cronbach's alpha 0.82). Coping strategies were assessed with an adapted version of the coping behavior questionnaire devised by Weisman and Worden (1976). All items employed a four-point response scale ranging from never to often.…”

Section: Methodsmentioning

confidence: 99%

Explaining quality of life with crisis theory

Sprangers

Tempelaar²,

Heuvel³

et al. 2002

Psycho-Oncology

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Based on the premises of crisis theory, we expected cancer patients in‐crisis to report a poorer quality of life (QL) and cancer patients post‐crisis to report a similar level of overall QL in comparison to healthy individuals. To explain these hypothesized findings, we expected the coping resources and strategies of patients in‐crisis to be equally effective and those of patients post‐crisis to be more effective as compared to those of healthy individuals.The sample consisted of: (a) 217 consecutive cancer patients in the acute phases of their illness (patients in‐crisis); (b) 192 disease‐free cancer patients (patients post‐crisis); and (c) 201 randomly selected healthy individuals. Established measures of QL, self‐esteem and neuroticism (coping resources) and coping behavior (coping strategies) were mailed. As expected, patients in‐crisis reported a poorer QL (p<0.001) and patients post‐crisis a similar overall QL as compared to healthy individuals. There were no significant or systematic differences between the mean levels of coping resources and strategies between the respective groups. Two‐way analysis of variance indicated a group X coping resource interaction effect on overall QL for self‐esteem (p<0.01). As expected, the amount of variance of overall QL explained by self‐esteem was largest for patients post‐crisis (27%) and comparable for patients in‐crisis and healthy individuals (10 and 11%). Patients in‐crisis were not able to make their coping resources and strategies more effective, whereas patients post‐crisis seemed to have enhanced the effectiveness of self‐esteem in restoring their QL as compared to healthy persons. Copyright © 2002 John Wiley & Sons, Ltd.

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Section: Methodsmentioning

confidence: 99%

Explaining quality of life with crisis theory

Sprangers

Tempelaar²,

Heuvel³

et al. 2002

Psycho-Oncology

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“…Younger patients and women report higher levels of distress [7,11,14,15], and individuals with lung cancer, compared to individuals with other cancer diagnoses, also report higher levels of distress [15,17]. Approximately 43% of patients with lung cancer report clinically-significant levels of distress [15,18], compared to about 33% of patients with breast cancer and 32% of patients with colon cancer [15].…”

Section: Introductionmentioning

confidence: 99%

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

et al. 2007

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SummaryScreening for distress in cancer patients is recommended by the National Comprehensive Cancer Network, and a Distress Thermometer has previously been developed and empirically-validated for this purpose. The present study sought to determine the rates and predictors of distress in a sample of patients being seen in a multidisciplinary lung cancer clinic. Consecutive patients (N = 333) were recruited from an outpatient multidisciplinary lung cancer clinic to complete the Distress Thermometer, an associated Problem Symptom List, and two questions about interest in receiving help for symptoms. Over half (61.6%) of patients reported distress at a clinically significant level, and 22.5% of patients indicated interest in receiving help with their distress and/or symptoms. Problems in the areas of family relationships, emotional functioning, lack of information about diagnosis/treatment, physical functioning, and cognitive functioning were associated with higher reports of distress. Specific symptoms of depression, anxiety, pain and fatigue were most predictive of distress. Younger age was also associated with higher levels of distress. Distress was not associated with other clinical variables, including stage of illness or medical treatment approach. Similar results were obtained when individuals who had not yet received a definitive diagnosis of lung cancer (n = 134) were excluded from analyses; however, family problems and anxiety were no longer predictive of distress. Screening for distress in a multidisciplinary lung cancer clinic is feasible and a significant number of patients can be expected to meet clinical criteria for distress. Results also highlight younger age and specific physical and psychosocial symptoms as predictive of clinically-significant distress. Identification of the presence and predictors of distress are the first steps toward appropriate referral and treatment of symptoms and problems that contribute to cancer patients' distress.

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“…Patients who appear to be ready to handle such serious news are easy partners, but those who remain ambivalent, unable, or unwilling to face the dire reality of the situation pose a challenge to even the most skillful communicators. Most patients live in between these two extremes, reflecting healthy coping mechanisms designed to ease them into acceptance of an impending death [31][32][33]. Practical methods are available for oncologists to prepare and coach patients for this difficult conversation.…”

Section: Step 3 I-obtaining the Patient's Invitationmentioning

confidence: 99%

Confronting Therapeutic Failure: A Conversation Guide

Morgans

Schapira

2015

The Oncologist

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We reflect on the impact of bad news on both clinician and patient in the setting of cancer treatment failure. We review the classic six-step SPIKES (setting, perception, invitation for information, knowledge, empathy, summarize and strategize) protocol for giving bad news that has been widely adopted since it was first published in this journal in 2005. The goal of such a conversation guide is to describe both the process and the tasks that constitute vital steps for clinicians and to comment on the emotional impact of the conversation on the clinician. Confrontingtherapeutic failure isthe hardest task foroncologists.We offer practical tips derived from a thorough review of the evidence and our clinical experience. The Oncologist 2015;20:946-951Implications for Practice: Discussing the failure of anticancer therapy remains a very difficult conversation for oncologists and their patients. In this article, the process of confronting this failure is broken down into various components, and practical tips are provided for clinicians following a classic protocol for breaking bad news. Also addressed are the emotions of the oncologist and the reasons why these conversations are typically so hard. These insights are based on solid research intended to deepen the therapeutic connection between physician and patient.

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The Existential Plight in Cancer: Significance of the First 100 Days

Cited by 588 publications

References 4 publications

Explaining quality of life with crisis theory

Explaining quality of life with crisis theory

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

Confronting Therapeutic Failure: A Conversation Guide

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