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Biomedical subjects

Francis J Keefe

Publications and source records attributed to Francis J Keefe.

At least 55 records · Page 3Linked to original sources
PubMed2003

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Adult↗
PubMed2003

One- and two-item measures of pain beliefs and coping strategies.

Pain-related beliefs and pain coping strategies are central components of current cognitive-behavioral models of chronic pain, and have been found in numerous studies to be associated significantly with psychosocial and physical disability. However, the length of most measures of pain-related beliefs and coping restricts the ability of clinicians and researchers to perform a thorough assessment of these variables in many situations. The availability of very brief versions of existing scales would make possible the assessment of a range of important pain beliefs and coping strategies in settings where subject or patient assessment burden is an issue. In this study, one- and two-item versions of the subscales of several commonly used measures of pain beliefs and coping strategies were developed using both rational and empirical procedures. The findings support the validity of these brief subscales. The appropriate use and limitations of these measures are discussed.

Adaptation, Psychological↗
PubMed2003

Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients.

The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.

Adaptation, Psychological↗
PubMed2002

Point of view.

Explore the source record for details and available documents.

Comorbidity↗
PubMed2002

Perceptions of patients' self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers.

This study examined the degree of correspondence between lung cancer patients and their family caregivers in their perceptions of the patients' self-efficacy for managing pain and other symptoms of lung cancer, and the association of this correspondence to demographic, disease, and psychosocial variables. Thirty patients who were newly diagnosed with lung cancer and their primary family caregivers completed telephone interviews assessing the patient's symptoms, the patient's self-efficacy for managing symptoms, the quality of the relationship between the patient and caregiver, patient and caregiver psychological distress, and caregiver strain. Although patients and their caregivers showed a moderate degree of agreement in their perceptions of the patient's self-efficacy for managing pain and other symptoms, there was considerable variability in the degree of congruence. Factors that contributed to lower levels of congruence included low patient-rated self-efficacy, female gender of the patient, high patient psychological distress, and high caregiver strain. Caregivers were about evenly split in their tendency to overestimate versus underestimate the patient's self-efficacy. A poorer quality of relationship between the caregiver and the patient (as rated by the patient), high levels of patient-rated symptoms, and high levels of caregiver strain were associated with caregivers overestimating patient self-efficacy.

Adult↗
PubMed2002

Relationship between pain-specific beliefs and adherence to analgesic regimens in Taiwanese cancer patients: a preliminary study.

This pilot cross-sectional study aimed to 1) explore pain beliefs and adherence to prescribed analgesics in Taiwanese cancer patients, and 2) examine how selected pain beliefs, pain sensory characteristics, and demographic factors predict analgesic adherence. Pain beliefs were measured by the Chinese version of Pain and Opioid Analgesic Beliefs Scale-Cancer (POABS-CA) and the Survey of Pain Attitudes (SOPA). Analgesic adherence was measured by patient self-report of all prescribed pain medicine taken during the previous 7 days. Only 66.5% of hospitalized cancer patients with pain (n = 194) adhered to their analgesic regimen. Overall, patients had relatively high mean scores in beliefs about disability, medications, negative effects, and pain endurance, and low scores in control and emotion beliefs. Medication and control beliefs significantly predicted analgesic adherence. Patients with higher medication beliefs and lower control beliefs were more likely to be adherent. Findings support the importance of selected pain beliefs in patients' adherence to analgesics, suggesting that pain beliefs be assessed and integrated into pain management and patient education to enhance adherence.

Analgesics↗
PubMed2002

The assessment of pain behavior: implications for applied psychophysiology and future research directions.

Persons who have pain engage in behaviors such as resting in bed, taking medication, moving in a guarded fashion, or grimacing that communicate the fact that pain is being experienced. Pain-related behaviors increasingly are viewed as an important target in pain assessment. Traditionally, pain behavior has been assessed through interview or self-recording methods (e.g. diary records). Pain behaviors, however, are overt and can be recorded through direct observation. Over the past 20 years, observation methods have been developed to assess pain behavior in patients having persistent pain conditions. Although these methods are not widely used in applied psychophysiological settings, they potentially could be quite useful. The purpose of this paper is to review the literature on such observation methods. The paper is divided into five parts. The first part provides a description of the basic elements of pain behavior observation protocols. The second part presents information on the psychometric properties of the most commonly used protocols. The third part highlights applications of pain behavior observation protocols. The fourth part briefly describes the strengths and limitations of pain behavior observation. The paper concludes with a discussion of the implications of pain behavior observation for applied psychophysiology and future directions for research and practice in this area.

Behavior↗
PubMed2002

Behavioral medicine and clinical health psychology: introduction to the special issue, a view from the decade of behavior.

This collection of articles follows prior special issues on behavioral medicine published in the Journal of Consulting and Clinical Psychology in 1982 and 1992. From the vantage point of the Decade of Behavior, the field has grown in scope, depth of basic science foundations, and evidence of applied utility. Yet many challenges remain-especially in addressing a wide range of health problems across diverse populations and in a health care context characterized by rapid changes in technology and by a growing concern with costs and evidence-based practice.

Behavioral Medicine↗
PubMed2002

Recent advances and future directions in the biopsychosocial assessment and treatment of arthritis.

This article provides an overview of the emerging literature on biopsychosocial assessment and treatment for two of the most common forms of arthritis: osteoarthritis and rheumatoid arthritis. The article is divided into 3 parts. In the 1st part, the basic elements of the biopsychosocial approach to assessing and treating persons having arthritis is described. In the 2nd part, the authors evaluate studies of biopsychosocial approaches to the assessment of arthritis pain and disability. Six research areas are reviewed: learned helplessness, depression, stress, pain coping, self-efficacy, and the social context of arthritis. The 3rd part of the article reviews studies that testing the efficacy of biopsychosocial treatment approaches for persons having osteoarthritis and rheumatoid arthritis.

Adaptation, Psychological↗
PubMed2002

Behavioral medicine: 2002 and beyond.

This article highlights future directions for research and practice in behavioral medicine. Topics addressed include social and environmental issues, the role of technology, translational research, improving and developing interventions, and professional training and retraining.

Behavioral Medicine↗
PubMed2002

Automated telephone as an adjunct for the treatment of chronic pain: a pilot study.

The objective of this study was to test whether Interactive Voice Response (IVR) can be used to enhance the therapeutic outcome of patients receiving group cognitive behavioral therapy (CBT) for chronic pain. Ten subjects with chronic pain syndromes participated in 10 weeks of group CBT followed by 4 months of Therapeutic Interactive Voice Response (TIVR). Our specially designed TIVR is based on a computerized telephone system in which callers are asked questions and respond by using the telephone keypad. It was created to reinforce pain coping skills and to provide messages for relaxation, sleep induction, and emotional support that can be accessed by patients on demand. Within-subject analysis showed that maximum positive change for nearly all outcome measures was observed at the post-TIVR point. For some measures, improvement compared to baseline was significant after TIVR despite the fact it had not been significant after CBT. Measures showing this pattern included SF-36 Mental Health Composite Score (P < .0004), McGill Pain Questionnaire pain (P < .01), Coping Strategies Questionnaire Catastrophizing (P < .0006), Treatment Outcomes in Pain Survey Total Pain Experience (P < .03), and Perceived Family/Social Disability (P < .02). Our preliminary results suggest that TIVR can be used to improve coping skills adherence and to prevent relapse into pain behavior.

Journal Article↗
PubMed2000

Understanding the adoption of arthritis self-management: stages of change profiles among arthritis patients.

Clinical observations and recent studies suggest that arthritis patients vary considerably in their involvement in self-management efforts. In the literature on health promotion, there is growing recognition that patients may be at different stages of change with respect to the adoption of self-management strategies. The major goal of the present study was to examine whether cluster analysis could be used to identify homogeneous subgroups of patients having persistent arthritis pain based on their responses to a stages of change questionnaire. Participants in this study (103 patients having rheumatoid arthritis and 74 patients having osteoarthritis) completed a stages-of-change measure specific to adoption of a self-management approach to their arthritis. A cluster analysis identified five distinct subgroups of arthritis patients: (1) precontemplation - 44% of the sample; (2) contemplation - 11% of the sample; (3) preparation - 22% of the sample; (4) unprepared action - 6% of the sample; and (5) prepared maintenance - 17% of the sample. These subgroups are generally consistent with what might be expected based on the transtheoretical model of stages of change by Prochaska and DiClemente (Prochaska JO, DiClemente CC. Towards a comprehensive, transtheoretical model of change: states of change and addictive behaviors. In: Miller WR, Heather N, editors. Applied clinical psychology, 2nd ed. Treating addictive behaviors, New York: Plenum Press, 1998. pp. 3-24.), and may have important clinical implications. For example, it is possible that the arthritis subgroups identified may predict arthritis patients' participation in and responsiveness to pain-coping skills training, exercise interventions, or other formal self-management training programs. Also, one may be able enhance the outcomes of self-management interventions for arthritis by tailoring treatment to the patient's particular stage.

Adaptation, Psychological↗
PubMed2000

The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing.

One hundred and sixty-eight patients with osteoarthritis (OA) of the knees participated in this study. Of the participants, 72 were men and 96 were women. All participants completed the Arthritis Impact Measurement Scales (AIMS), underwent a 10 min standardized observation session to assess their pain behavior, and completed the Catastrophizing Scale of the Coping Strategies Questionnaire (CSQ) and the Depression Scale of the Symptom Checklist 90 Revised (SCL-90R). The study found that there were significant differences in pain, pain behavior, and physical disability in men and women having OA. Women had significantly higher levels of pain and physical disability, and exhibited more pain behavior during an observation session than men. Further analyses revealed that catastrophizing mediated the relationship between gender and pain-related outcomes. Once catastrophizing was entered into the analyses, the previously significant effects of gender were no longer found. Interestingly, catastrophizing still mediated the gender-pain relationship even after controlling for depression. These findings underscore the importance of both gender and catastrophizing in understanding the OA pain experience and may have important implications for pain assessment and treatment.

Aged↗
PubMed1999

Everyday life with osteoarthritis or rheumatoid arthritis: independent effects of disease and gender on daily pain, mood, and coping.

The effects of disease (form of arthritis) and gender on pain, mood, and pain coping strategies were examined in a prospective 30-day diary study of 71 patients with osteoarthritis (OA) and 76 with rheumatoid arthritis (RA). Diary instruments included joint pain ratings, POMS-B checklists for positive and negative mood, and the Daily Coping Inventory. Women's average daily pain was 72% greater than men's pain, and RA patients' average daily pain was 42% greater than OA patients' pain. Hierarchical Linear Models were estimated for (a) within-person associations between pain and next-day mood; coping and next-day pain; and coping and next-day mood; and (b) the independent effects of disease and gender on individual intercepts for pain, mood, and coping and on individual slopes for pain-coping-mood relations. Women, regardless of their disease, and RA patients, regardless of their gender, reported more daily pain. Women used more emotion-focused strategies each day than did men, regardless of their disease and even after controlling for their greater pain. Men were more likely than women to report an increase in negative mood the day after a more painful day. RA patients' pain worsened, but OA patients' pain improved, following a day with more emotion-focused coping. Implications for research and clinical practice are summarized.

Adaptation, Psychological↗
PubMed1997

Pain coping strategies that predict patients' and spouses' ratings of patients' self-efficacy.

This study examined the relationship of pain coping strategies to osteoarthritis patients' ratings of self-efficacy and to spouses' ratings of the patients' self-efficacy. Subjects, 130 individuals having osteoarthritis of the knees and persistent knee pain, completed a pain coping strategies measure (the Coping Strategies Questionnaire), a measure of self-efficacy (the Arthritis Self-Efficacy Scale), and a measure of pain (the McGill Pain Questionnaire). Two sets of regression analyses were conducted, one examining the degree to which pain coping strategies predicted patients' self-efficacy ratings, and the other examining the degree to which coping strategies predicted spouses' ratings of the patients' self-efficacy. Several pain coping strategies were found to predict a significant proportion of variance in patients' ratings of self-efficacy: (i) ignoring pain sensations was related to higher self-efficacy for pain; (ii) coping self statements were related to higher self-efficacy for controlling other arthritis symptoms (e.g., fatigue or mood symptoms: and (iii) catastrophizing was related to lower self-efficacy for pain, and self-efficacy for other arthritis symptoms. Pain coping strategies were also found to predict a significant proportion of variance in spouses' ratings of the patients' self-efficacy. Specifically: (i) diverting attention was related to lower spousal ratings of self-efficacy for pain; (ii) praying or hoping was related to lower spousal ratings of self-efficacy for function; and (iii) catastrophizing was related to lower spousal ratings of self-efficacy for control of fatigue or mood symptoms. The findings regarding coping strategies were particularly interesting in that they were obtained even after controlling for pain intensity and demographic variables. The pain coping strategies identified are potentially important targets for cognitive-behavioral assessment and treatment efforts. Interventions designed to increase the use of adaptive pain coping strategies and decrease the use of maladaptive pain coping strategies could enhance self-efficacy, reduce pain, and improve the physical and psychological functioning of individuals having osteoarthritis.

Adaptation, Psychological↗