[Supportive care].
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Biomedical subjects
Publications and source records attributed to J F Pruyn.
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Investigated late psychosocial sequelae in 133 parents of children who survived cancer, using questionnaires developed to measure the specific impact of the disease. Childhood cancer had distinct and persistent late psychosocial effects on parents of survivors. Uncertainty and loneliness were the most reported problems. Demographic and situational characteristics such as being a mother, low SES, no religious affiliation, chronic disease in a family member other than the child surviving cancer, and concurrent stresses increased the risk of reporting late problems. Treatment itself had little or no effect on reported problems. However, when treatment led to long-term sequelae in the child, a significant and specific effect on parental problems was observed. No decline of problems over time was found, which has implications for patient care.
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An experiment was conducted to assess the effects of different types of sentences and recording methods on naive judges' evaluations of the speech communication effectiveness of four patients who had undergone surgery for oral cancer. As expected, judges understood patients better if they read meaningful rather than meaningless sentences and if their speech was evaluated under video rather than audio conditions. However, these general findings were qualified because of the powerful influence of individual differences among patients. For example, whereas the intelligibility of three of the patients increased under the audio condition if the sentences being read were meaningful, one patient was poorly understood no matter what type of sentence he read under the same condition. The results suggested that the identification of the unique personality characteristics of patients that are related to their intelligibility merits serious consideration by both researchers and rehabilitation clinicians.
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This study is a systematic analysis of the literature on psychosocial aspects in head and neck cancer patients. Patients with head and neck cancer experience a variety of physical as well as psychosocial problems. Physical problems include swallowing or chewing, speech and physical appearance. Psychosocial problems include anxiety, depression, loss of self-esteem and uncertainty about the future. Because of these problems, isolation from friends typically occurs, re-employment is difficult, and there are social and sexual tensions within families. Information and support by professionals, partners and/or fellow patients are related to positive rehabilitation outcomes such as the acquisition of speech, increases in constructive social functioning and decreases in depression.
Breast cancer patients and patients with Hodgkin's disease (N = 663) were contacted initially by medical specialists at 15 medical centers across The Netherlands and subsequently 498 of them were interviewed in their homes in order to examine interactions between their personality characteristics, their assessment of the adequacy of information feedback from their physicians about their illness, its treatment and prognosis, and their adoption of an unproven diet remedy. The data indicate that patients who believed they had received insufficient and unclear information were more likely to be adopters of the Moerman diet than patients who believed the information was adequate. Personality moderator analyses indicated further that the relationship between information adequacy and diet adoption held specifically for those patients with high trait anxiety, low self-esteem, angry-aggressive coping styles or impulsive attitudes. The discussion focused on rational and irrational elements in physician-patient communications, the strategies available to physicians to improve their communication skills, the desirability of constructing and distributing educational and informational materials for use by patients, and the need for physicians to offer their patients an opportunity for contact with companions in distress.
BACKGROUND: Little is known about the rehabilitation outcomes of long-term survivors following treatment for head and neck cancer. There are, for example, no studies on physical and psychosocial rehabilitation outcomes of T1 glottic larynx carcinoma, despite the fact that these form the majority of head and neck cancer sites. Thus, this investigation afforded a unique opportunity for examining similarities and differences among T1 glottic larynx patients, laryngectomy patients, and those who had surgery for cancer of the oral cavity and/or oropharynx along a variety of physical and psychosocial dimensions. METHODS: To describe the impact of these three types of head and neck cancer and their treatment on the physical and psychosocial functioning of long-term survivors, a self-report questionnaire was completed by 110 patients treated between 2 and 6 years previously in a major cancer center. RESULTS: Data indicate that a higher percentage of patients treated with laryngectomy or commando procedures still experience severe psychosocial distress between 2 and 6 years after their last treatment than do patients treated with radiotherapy for a T1 carcinoma of the glottic larynx. Psychosocial and physical complaints are still reported by many laryngectomy patients, apparently the result of problems in effective communication with others. Many commando procedure patients experience problems with respect to food intake, and with disfigurement and its consequences. T1 larynx patients mainly experience a considerable number of physical complaints. The greater the time that had elapsed since treatment, the fewer the psychosocial problems associated with head and neck tumors. Open discussion of the illness in the family, social support, and perceptions of adequate information from the specialist are the most important predictors of positive rehabilitation outcomes. CONCLUSIONS: This study indicates that T1 larynx patients report many physical complaints even though several years had elapsed since treatment. Also, laryngectomy patients may need psychosocial guidance for a longer posttreatment period and that health care personnel must involve the partner as much as possible in all communications. Commando procedure patients in particular feel hindered by their disfigurement and its consequences. Future research with respect to validation of the specific head and neck modules is needed.