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Biomedical subjects

F M Lewis

Publications and source records attributed to F M Lewis.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Women with chronic illness: their views of their families' adaptation.

Although research has characterized the effects of chronic illness on patients and their spouses, little work has addressed the effects of a woman's chronic illness on her family. We tested a model of family functioning during a woman's chronic illness. Data were obtained from standardized questionnaires from 48 women who resided with an adult partner and one or more school age children and had breast cancer, diabetes, or fibrocystic breast disease. Path analysis indicated that the women experienced more demands associated with their illness as the time since their initial diagnosis lengthened. The number of demands associated with the illness in turn produced problems with marital adjustment. Introspective coping behaviors were used more frequently by families in which the woman experienced high marital adjustment but depressed mood than by families in which the woman was not depressed but experienced marital difficulties. Women's relationships with their children were positively influenced by better marital adjustment, and women who had positive relationships with their children described their children's relationships with their peers as positive. Family functioning was optimum when the family frequently engaged in introspective coping behavior, when the woman had a low level of depressed mood, and when marital adjustment was positive.

Adaptation, Psychological↗
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The impact of marital status and quality on family functioning in maternal chronic illness.

Married individuals tend to enjoy greater health and well-being than nonmarried. However, investigators disagree about whether this is related to the quality of the marriage or to participation in the socially accepted role of marriage. In the present study, we examined the roles of marital quality and marital status as predictors of the family's adjustment processes in the context of maternal chronic illness. We found that the family functioning of single women and unhappily married women was similar and that happily married women enjoyed higher levels of family functioning and family coping. Unhappily married women reported more illness demands, particularly on their time and energy, than did happily married or single women. We suggest it is the quality of the marital interaction, and not the role benefits of marriage, that facilitates family adjustment under conditions of maternal chronic illness.

Adaptation, Psychological↗
PubMedDate not supplied

Psychosocial adjustment to breast cancer: a review of selected literature.

The following is a review of the clinical and research literature concerning women's emotional adjustment to the detection of breast cancer and its subsequent management. The review is organized into ten themes which focus on three general areas: 1) women's response to the diagnosis of breast cancer; 2) involvement of spouse, family and professional providers; and 3) the patient's milieu--how it impinges on the course of her treatment and rehabilitation. Also noted is the paucity of systematic research dealing with the effectiveness of support interventions, their content and duration, and the appropriate individual to provide such support.

Adaptation, Psychological↗
PubMedDate not supplied

Mother and child interactions about the mother's breast cancer: an interview study.

PURPOSE/OBJECTIVES: To describe mothers' reported methods of interacting with the mothers' school-age children about their breast cancer. DESIGN: Qualitative. SETTING/SAMPLE: 19 mothers newly diagnosed with breast cancer. Mothers received treatment for their illness in the Pacific Northwest. Mothers had at least one child between 7 and 12 years old at the time of diagnosis. METHODS: Case-intensive, in-home, semistructured interviews were audiotaped, transcribed, and inductively coded into four conceptual domains and 16 categories of behavioral strategies used by the mothers to interact with their children about the breast cancer. MAIN RESEARCH VARIABLES: Behavioral strategies used by mothers when interacting with the children about the breast cancer and when providing children with support. FINDINGS: Mothers used a number of methods to bring children into the mothers' breast cancer experience. The conceptual domains included talking about the breast cancer, explaining treatment and care, providing experiences, and doing things to help children cope. CONCLUSIONS: The dominant pattern in the interview data was for mothers to assume a teacher/educator role with the children about the cancer, not an interactive, emotive-expressive parenting role. Most mothers used technical biomedical language; did not give evidence of systematically checking on the children's understanding of what they were told; did not elicit the children's concerns; and exposed the children to emotionally laden or potentially frightening images, words, or experiences. IMPLICATIONS FOR NURSING PRACTICE: Programs and materials need to be developed that help mothers work from a model of parenting that includes developmentally appropriate language, facilitates the children's expression of questions and feelings, links the mothers with the children's understanding of the illness, and assists the children to better manage what is happening related to the breast cancer.

Adaptation, Psychological↗
PubMedDate not supplied

Psychosocial adjustment of the family to breast cancer: a longitudinal analysis.

The purpose of the current study was to assess the impact of the mother's breast cancer on her family during rehabilitation and to determine the processes families use to adjust to the illness over time. Data were obtained from 111 child-rearing mothers with breast cancer on three occasions at four-month intervals using standardized measures of psychosocial adjustment. Results revealed that over time the families experienced significantly lower levels of illness-related demands and the marriages became better adjusted. Levels of depressive mood in the women, however, remained stable. This negative mood negatively affected the quality of the marriage, which, in turn, caused the family to cope less frequently with its problems and to function less well. Results strongly suggest the importance of formally assessing the woman's level of depressed mood and channeling women with stable depressive mood and their families into more intensive support services than those typically provided. Evidence from the current study is that, when not attended to, this depressive mood has sustained, deleterious effects on how well the family does during rehabilitation.

Adaptation, Psychological↗
PubMedDate not supplied

How children cope with mother's breast cancer.

Few studies have focused on the child of a parent with cancer. Family systems and cognitive development theories suggest that the mother's illness affects the children and that families take action to help them. This study describes the ways in which school-age children cope with the mother's breast cancer and the ways in which their families help them cope. The results are based on semistructured interviews with 81 children 6-20 years old whose mothers had been diagnosed with breast cancer within the past two-and-a-half years. Interviews were tape-recorded, transcribed, and content analyzed. Eighty-four percent agreement on interrater reliability was achieved using three independent trained coders. Children and families used four types of strategies: acted as though they were in her shoes, carried on business as usual, tapped into group energy, and put her illness on the table. Parents, other family members, the children's friends, and adult friends helped the children. The results suggest ways that clinicians can understand the effect of the mother's breast cancer from the child's perspective and thus facilitate both the child's coping and the family's attempts to help the children.

Adaptation, Psychological↗
PubMedDate not supplied

Experienced personal control and quality of life in late-stage cancer patients.

This study examined the association of experienced personal control and quality of life for late-stage cancer patients within the context of Rotter's Social Learning Theory and Seligman's Theory of Learned Helplessness. It was hypothesized that in late-stage cancer patients greater control would be associated with a higher quality of life as measured by self-esteem, anxiety, and perceived self-esteem, anxiety, and perceived meaningfulness. The longer the history of the disease, the lower would be the individual's level of experienced personal control and quality of life. Fifty-seven late-stage cancer patients completed four standardized instruments: the Rosenberg Self-Esteem Scale; the Health Locus of Control Scale (HLC); the Lewis, Firsich, and Parsell Attorney Scale; and the Crumbaugh Purpose-in-Life Test. As predicted, the measure of experienced personal control over life significantly correlated with scores on the self-esteem scale (tau = -.33; p = .001), and the anxiety scale (tau = -.30; p = .001). Contrary to prediction, scores on the Health Locus of Control Scale were only significantly associated with scores on the Purpose-In-Life Test (tau = -.18; p = .05). Length of history of disease was significantly related to scores on the HLC Scale (tau = .27; p = .007) and to scores on the anxiety scale (tau = .20; p = .03) but was not significantly associated with scores on the self-esteem scale or the Purpose-In-Life Test.

Adult↗
PubMedDate not supplied

Behavioral adjustment and self-esteem of school-age children of women with breast cancer.

PURPOSE/OBJECTIVES: To describe children's psychosocial adjustment to their mother's breast cancer and to compare their level of adjustment with normative data and with the level of adjustment of children of women with fibrocystic breast disease or diabetes. Hypotheses tested were (a) children of women with breast cancer would be most negatively affected and (b) families of mothers with fibrocystic breast disease would require less family adaptation than families of women with breast cancer or diabetes. DESIGN: One component of a larger longitudinal survey. SETTING: University-based physician clinic in a metropolitan area in the Northwestern United States. SAMPLE: Mothers, predominantly Caucasian, with medically controlled diabetes mellitus (n = 18), nonmetastatic breast cancer (n = 13), or biopsy-proven fibrocystic breast disease (n = 17) and their children (N = 48), who ranged in age from 6 to 12. METHODS: Five in-home interviews conducted at four-month intervals. MAIN OUTCOME MEASURES: Behavioral adjustment using the Louisville Behavior Checklist (maternal report) and the Zeitlin Coping Inventory (nurse-observer report) and self-esteem using the Personal Attribute Inventory for Children (children's self-report). FINDINGS: Children of women with breast cancer scored better than average on behavioral adjustment (mothers' ratings) and were judged by nurse observers to be better behaviorally adjusted than children in the noncancer illness groups. Children of women with breast cancer and of women with diabetes tended to score significantly lower on self-esteem than the comparative sample. CONCLUSIONS: Measures of childhood adjustment to chronic medical illness in mothers need to distinguish between behavioral adjustment and self-esteem. Discrepancies between child ratings and mother and nurse-observer ratings suggest that differences exist. IMPLICATIONS FOR NURSING PRACTICE: Findings are preliminary in nature, and other explanations for findings must be ruled out. However, if a child's self-appraisal is affected negatively by the mother's illness, it would be appropriate to identify ways to increase emotional and physical exchange with the child and to interpret inaccessibility in ways that protect the child's positive self-appraisal.

Adaptation, Psychological↗
PubMedDate not supplied

The functioning of single women with breast cancer and their school-aged children.

Although there are significant numbers of single women with breast cancer who are rearing children, there is no known study of their own or their school-aged children's adjustment to the illness. The purposes of this study are: 1) to describe the adjustment of single women to early stage breast cancer; 2) to contrast their responses to a comparable sample of married/partnered women; 3) and to document the psychosocial functioning of school-aged children when their single mother has breast cancer. Results obtained from questionnaire data from 22 single and 101 married/partnered women revealed that single women had significantly higher rates of depression; reported significantly higher numbers of illness-related pressures on their family; had a significantly higher proportion of young children scoring in the abnormal range on measures of self-worth and social acceptance; and reported lower quality in parenting their children. Interviews with single women revealed that many were burdened by feelings of self-deprecation because of their breast cancer, and many felt alone with the disease through the initial diagnosis period, during treatments, and through recovery. Evidence from this pilot study suggests that single women need early and immediate linkage into an informational and educational network and a viable adult support network.

Adaptation, Psychological↗
PubMedDate not supplied

The nurse as coach: a conceptual framework for clinical practice.

PURPOSE/OBJECTIVES: To operationalize a professional educational counseling model for nurses that derives from the client's frame of reference and adds to the client's behavioral management of the impact of cancer, including self-care skills and cognitive control. DATA SOURCES: Published literature and four years of clinical experience with 84 couples in which coaching behavior was applied in home-based intervention sessions. DATA SYNTHESIS: Nurse coaching behavior includes six dimensions. Attending to the Story, Encircling the Experience, inviting the Work, Exploring Solutions, Anchoring the Skill, and Setting Up Success. CONCLUSIONS: Nurse coaching behavior is designed to facilitate the cognitive emotional processing of the cancer experience and to add to the patient and family member's repertoire of behavioral self-care and self-management skills. Future research is needed to evaluate the processes and outcomes of nurse coaching behavior when working with patients and family members experiencing cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurse coaching provides a practice framework that complements patient teaching and supportive therapy as a method for enhancing self-care and self-management behavior for people with cancer and their family members.

Adaptation, Psychological↗