Search PubMed⌕ Search

Biomedical subjects

D F Cella

Publications and source records attributed to D F Cella.

72 records · Page 4Linked to original sources
PubMed1987

A brief POMS measure of distress for cancer patients.

The authors describe an 11-item short form of the Profile of Mood States' 58-item Total Mood Disturbance Score (TMDS). The Brief TMDS was derived from a sample of 619 adults with mixed cancer diagnoses, and replicated on a second sample of 295 lung cancer patients. Internal consistency of the Brief TMDS and the correlations of the Brief TMDS with the full TMDS were highly satisfactory for both samples. Given the difficulty many medically ill people have with lengthy self-report scales, and the increasing importance of measuring distress as an adjunct to patient care, this measure shows promise as a rapid, reliable tool.

Affect↗
PubMed1987

Death anxiety in cancer survival: a preliminary cross-validation study.

In an attempt to cross-validate the results with cancer survivors and to test its sensitivity to illness-related variables, the Death Anxiety Questionnaire (DAQ) was administered with measures of general anxiety, depression, somatization, and global psychological distress to 90 young adult men (60 Hodgkin's disease survivors, 30 testicular cancer survivors). There were no differences between groups on any of the dependent measures. Significant but weak to moderate intercorrelations confirmed that death anxiety is separate but related to general anxiety, depression, somatic distress, and global psychological distress. The DAQ was the most highly correlated with time elapsed since diagnosis, but no measure was significantly associated with extent of the disease at diagnosis (i.e., prognosis). Factor analysis of the DAQ provided confirmation of its multidimensionality and lent partial support to the presence of previously reported specific dimensions. The factor structure of the DAQ in cancer survivors may be different from that in the general population. Further study is needed to examine this aspect.

Adult↗
PubMed1987

Ego identity status, identification, and decision-making style in late adolescents.

Measures of identification with same-sex parent and decision-making style were administered to 30 male and 30 female late adolescents who had been classified by Marcia's (1964) criteria as either identity achieved, foreclosed, moratorium, or diffused. As predicted, male and female foreclosed subjects were more impulsive than were those in the other statuses, and male moratorium subjects were more reflective than others. However, female moratoriums were impulsive, and male and female diffused were reflective, findings which contradict theoretical expectation. Similarly, data on identification were mixed; female achieved subjects scored (as predicted) with higher identification than female moratorium or diffused subjects, while diffused males were highly identified with their fathers. One reason offered for the conflicting results is that identity formation is, as some have suggested, a different process for women than it is for men. Therefore, study of both genders with the same measures and hypotheses is not recommended.

Adolescent↗
PubMed1984

The modified WAIS-R: an extension and revision.

The Modified WAIS-R (WAIS-RM) is an approach that integrates the procedures of Vincent (1979) and Himelstein (1983). Using the information subtest score as a guide, starting points on 7 of the remaining 10 subscales are upgraded in a way that can shorten administration time of the WAIS-R by as much as 30%. WAIS-R to WAIS-RM correlations for Verbal, Performance, and Full Scale IQs were .995, .996, and .998, respectively (N = 50). Subtest scatter profiles were shown to be retained accurately. This approach appears to have promise as a shortened WAIS-R that retains its clinical utility.

Adolescent↗
PubMedDate not supplied

Missing quality of life data in cancer clinical trials: serious problems and challenges.

Measurement of quality of life (QOL) in cancer clinical trials has increased in recent years as more groups realize the importance of such endpoints. A key problem has been missing data. Some QOL data may unavoidably be missing, as for example when patients are too ill to complete forms. Other important sources are potentially avoidable and can broadly be divided into three categories: (i) methodological factors; (ii) logistic and administrative factors; (iii) patient-related factors. Logistic and administrative factors, for example, staff oversights, have proven to be most important. Since most QOL measurements require patient self-report, it is usually not possible to rectify the failure to collect baseline data or any follow-up assessments. There is strong evidence that such data are not 'missing at random', and cannot be ignored without introducing bias. Although several approaches to the analysis of partly missing data have been described, none is entirely satisfactory. Prevention of avoidable missing data is better than attempted cure. In July 1996, an international conference on missing QOL data in cancer clinical trials reported the experience of most major groups involved. This paper will serve as an introduction to the problem and provide an estimation of its magnitude, and approaches to its prevention and solution.

Bias↗
PubMedDate not supplied

An analysis of the impact of demographic, clinical, and social factors on health-related quality of life.

This study investigated the impact of demographic, social, and clinical factors on cancer patients' self-ratings of health-related quality of life (HRQL). The sample consisted of 1342 ethnically diverse individuals in treatment at four member institutions of the Eastern Cooperative Oncology Group (ECOG). Multivariable regression analyses were employed to determine the relationship between demographic variables (age, gender, race/ethnicity, socio-economic status (SES), living arrangement), clinical factors (performance status rating (PSR), disease type, disease stage), and social characteristics (spiritual beliefs, religious affiliation, relationship with physician) and five outcome measures of HRQL. The dependent variables, four dimensions of HRQL and overall HRQL, were measured by the Functional Assessment of Cancer Therapy-General (FACT-G) Quality of Life Measurement System. The results indicated that the full set of predictor variables accounted for 45% of the variance in patients' reporting of overall HRQL, 25% of the variance in physical well-being, 27% of the variance in social well-being, 30% of the variance in emotional well-being, and 41% of the variance in the area of functional well-being. The findings suggest that there are multiple factors that influence an individual's assessment of their HRQL and that these factors need to be considered in the management and treatment of culturally diverse cancer patients.

Journal Article↗
PubMedDate not supplied

The influence of stress management training in HIV disease.

A pretest-posttest design (with a 6-week wait-list control and a 6-month comparison group) was used to compare the effectiveness of a 6-week stress management training program with standard outpatient care for 45 men with HIV disease. Outcomes included stress levels, coping patterns, quality of life, psychological distress, illness-related uncertainty, and CD4+ T-lymphocyte levels. At 6 weeks, intervention was associated with increases in the emotional well-being dimension of quality of life. After 6 months, the intervention group had a relative decline in HIV-related intrusive thinking, indicating that stress management training may have buffered illness-related psychological distress over time.

Adult↗
PubMedDate not supplied

Overcoming difficulties in demonstrating health outcome benefits.

Nutrition interventions with cancer patients may produce benefits beyond those typically evaluated, such as increased appetite, food intake, and weight gain. Other benefits include enhanced mood, improved sense of well-being, and increased socialization because of an increased ability to eat in public or with family. Along with the target benefits of nutrition interventions, these "untargeted" benefits have come to be clustered under the general rubric of health-related quality of life. All medical treatments, including nutrition interventions, can be evaluated in terms of their total effect upon health-related quality of life. However, demonstrating health outcome benefits of nutrition interventions can be very difficult. This difficulty is at two levels: conceptual and practical. Conceptual difficulties can be overcome by refining and clarifying the definition and measurement of health-related quality of life. Practical difficulties are more diverse and must be tackled on a point-by-point basis, depending upon the unique characteristics of the disease being treated, the intervention being tested, and the context of the trial. This paper offers some guidelines and recommendations for overcoming many of the more commonly confronted barriers to successful demonstration of health outcome benefits from clinical nutrition trials with cancer patients.

Clinical Trials as Topic↗
PubMedDate not supplied

Psychosocial adjustment to recurrent cancer.

This descriptive study of the perceptions and needs of people with recurrent malignancies asks three questions: How do patients describe the meaning of a recurrence of cancer? Do individuals perceive the diagnosis of recurrence and the initial diagnosis of cancer differently? What are the key psychosocial problems associated with recurrent cancer? The theoretical framework was based on Lazarus and Folkman's theory of stress, appraisal, and coping. Subjects completed the Impact of Event Scale (IES), the Psychosocial Adjustment to Illness Scale--Self-Report (PAIS), and a semistructured qualitative interview. The interview elicited perceptions of the event of recurrence and differences between the diagnosis of recurrence and the initial diagnosis. The convenience sample included 40 patients diagnosed with recurrent cancer within the last 30 days. Many subjects (78%) reported that the recurrence was more upsetting than the initial diagnosis. Scores on both the IES and the PAIS were high when compared to normative samples of patients with cancer suggesting that this sample of patients experienced a lot of psychological distress as well as problems at home, work, and in their social lives. These concerns often were unknown to caregivers. Although more research is needed, the authors propose that, with more accurate assessment, more effective intervention could be implemented and the quality of life improved for patients with recurrent cancer.

Adaptation, Psychological↗
PubMedDate not supplied

Cancer support groups: the state of the art.

Support groups serve a large number of people with cancer, and their family members. Their popularity is grounded in the fact that the existing cancer treatment network continues to leave a gap of unmet psychosocial needs. These unmet needs can often be alleviated by mutual aid provided by people who share a common experience. Mutual aid complements professional help by adding a dimension of support that is best provided by other members of the group in need. Themes of discussion in support groups include the emotional impact of illness, the meaning of illness, family difficulty, problems of intimacy, sense of isolation/stigma, role changes, and cancer-specific concerns. Components of mutual aid witnessed in these groups include direct assistance, advice-giving, and emotional support. In cancer support groups, there is an under-representation of people of color, men, and the poor among group participants. Out-reach to underserved groups must include more creative and flexible helping mechanisms.

Health Services Needs and Demand↗