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PubMedDate not supplied

Cancer survivor identity and quality of life.

PURPOSE: The purpose of this article is to propose a framework for enhancing an understanding of quality of life among cancer survivors that takes into account individuals' subjective experiences and attributions of self as they relate to their own experience with cancer. OVERVIEW: This review of a small yet burgeoning cancer survivorship literature posits that there is room to expand the theoretical context for understanding cancer and its impact on quality of life by assuming that the experience of cancer involves changes in social roles and identity. In turn, changes in the way cancer survivors see themselves in relation to the world, including the ability to carry out roles and responsibilities, may affect quality of life. This perspective suggests that a cancer diagnosis initiates a survival trajectory and a social role that extends over the remainder of one's life, regardless of life expectancy. CLINICAL IMPLICATIONS: Expanding the understanding of quality of life and the factors that contribute to it should help subsequent investigations of who might benefit from which psychosocial support interventions provided when (i.e., during early diagnostic stage, treatment stage, or both or in the long term). Equipped with this understanding, clinicians and agencies providing services to cancer survivors and their families can develop appropriate supportive interventions that facilitate and enhance quality of life.

Adaptation, Psychological↗
PubMed2002

[Do psychological factors change in patients with spasmodic dysphonia after injections with botulinum-toxin?].

OBJECTIVE: A pre-/posttherapeutic comparative study was carried out to investigate possible associations of voice symptoms, selected psychological factors and their changing. SAMPLE: A total of 11 patients with spasmodic dysphonia (adductor-type) subjected to botulinum-toxin-therapy. Patients had received treatment without any complications for at least 2 years. During that period of time, they received a minimum of 3 and a maximum of 9 injections (mean: 6). METHODS: Psychosocial data were measured before and after treatment using standardized psychological methods. The time span between measurements ranged from 1;8 to 4;6 years, with an average of 2;1 years. RESULTS: On average, no somatic disorder, no clinically meaningful states of anxiety or pathological manifestations of personality traits could be detected, neither pre- nor posttherapeutically. The average stress load caused by life-changing-events was unobtrusive. Before treatment, 5 of 11 patients had an affective disorder in terms of a depressed mood. This caused a higher than average mean depressivity score for the group as a whole. It was no longer found posttherapeutically. CONCLUSION: The depression is interpreted as a psychic reaction. An association between spasmodic voice symptoms and psychosocial genesis could not be proved.

Adult↗
PubMed1977

Projective and identificatory illnesses among ex-hunter-gatherers: a seven-year survey of a remote Australian aboriginal community.

THIS article attempts to provide answers from a psychiatric viewpoint to the question posed by Tindale (1974) in the opening paragraph of his Aboriginal Tribes of Australia: "What happens when a few small groups of people of family size are wresting a living from a given area of land by searching for food, over whose presence or growth they have no direct control?" Such very small-scale societies were a necessity in the Australian environment, where the Aboriginals were obliged to live by hunting and gathering. Indeed, the life-style of all manking was similar to this through most of the time span of human existence. The survey on which this article is based examined a community not long removed from that life-style, and found the defense mechanisms of projection and identification, which apparently persist because of their ancient function in assisting the adjustment of the individual and the group in these very small-scale societies. Some clans in this area have been in continuous contact with whites for only 25 years, and the others for about 60 years, so it is unlikely that the modal defenses of the people have changed. The child-rearing patterns that contributed to the defenses, appropriate to a society organized into clans, probably also have not changed significantly. Intensified by stresses of modern origin, these defenses shape the psychiatric illnesses of today.

Adult↗
PubMedDate not supplied

Coping, life-style changes, health perceptions, and martial adjustment in middle-aged women and men with cardiovascular disease and their spouses.

This descriptive study was designed to compare the coping responses, life-style changes, health perceptions, and current marital adjustment in 11 middle-aged women (CD women) with those of 37 men (CD men) who had been diagnosed as having cardiovascular disease. A secondary purpose was to compare their spouses' responses on these same measures. Participants were comparable on demographic and illness characteristics. CD women differed from CD men for the three coping responses of distancing, accepting responsibility, and planful problem-solving; for the total health perceptions scale; and for the current health and resistance to illness subscales. The CD women and CD men differed from their partners in total health perceptions, current health, and resistance to illness. CD women and their husbands were more dissimilar in their coping responses than were CD men and their wives. Age and pre-illness satisfaction were significant predictor variables for the coping strategies of distancing and accepting responsibility.

Adaptation, Psychological↗
PubMedDate not supplied

Brief uncontrollable stress and psychological parameters influence human plasma concentrations of IgM and complement component C3.

Thirty-eight men participated in a study of immunological, hormonal, and psychological parameters before and after acute stress situations. A brief but acute stress was repeated daily for 4 days. This exposure caused the plasma levels of IgM and C3 to increase from Basal Day to Experimental Day 4. Significant correlations between endocrine and immunological parameters, and also between psychological measures and immunological parameters, were found. Use of psychological defense was related both to endocrine and immunological changes. The authors concluded that psychological stress may influence immunological functions both indirectly, by hormonal changes, and directly, by nervous regulation during brief but acute stress periods.

Adult↗
PubMed1996

Predicting completeness of symptom relief after major heart surgery.

The authors hypothesized that the same biopsychosocial factors that raise the risk of illness incidence would influence the speed and completeness of relief from physical symptoms during recovery following cardiac surgery. This multicenter prospective study involved 463 patients aged 35 to 69 years who underwent coronary artery bypass graft or cardiac valve surgery. Predictor data were gathered 1 to 3 days before surgery, and outcome measures were collected 6 months postoperatively. The following predictors were associated with postoperative freedom from cardiac symptoms: fewer preoperative cardiac hospitalizations; low levels of angina, dyspnea, fatigue, and sleep problems; low levels of anxiety, depression, hostility, and life-change events; and high levels of psychosocial well-being, hopefulness, overall satisfaction, and social support. The predictors of not requiring daytime bed rest because of cardiac symptoms during the 6th postoperative month were male gender, higher education, less cardiac disability preoperatively, low levels of angina, dyspnea, sleep problems, depression and fatigue, and absence of Type A behavior and of intraoperative hypotension. By using separate multiple logistic regression equations, the authors identified the variables printed in bold face as independent significant contributors to prediction. Many of the predictors are strong enough and simple enough to be used in clinical practice. Many of them may also predict recovery after acute illnesses and injuries involving other organ systems.

Activities of Daily Living↗
PubMed2002

Social ties and change in social ties in relation to subsequent total and cause-specific mortality and coronary heart disease incidence in men.

The authors prospectively examined the effects of social ties and change in social ties, as measured by a well-known social network index, on total and cause-specific mortality and on coronary heart disease incidence in 28,369 US male health professionals aged 42-77 years in 1988. Over 10 years, the relative risk of total mortality for men in the lower two levels of social integration compared with more socially integrated men was 1.19 (95% confidence interval: 1.06, 1.34) after controlling for age, occupation, health behaviors, general physical condition, coronary risk factors, and dietary habits. In multivariate analysis, deaths from accidents and suicide and from other noncancer, noncardiovascular causes were significantly increased among less socially connected men. Socially isolated men also had an increased risk of fatal coronary heart disease (multivariate relative risk = 1.82, 95% confidence interval: 1.02, 3.23). An increase in the overall social network index between 1988 and 1996 was not significantly associated with subsequent 2-year mortality. In analyses of change in social network components restricted to older men, each categorical unit increase in number of close friends was significantly associated with a 29% decrease in risk of death. Increase in religious service attendance over time was also significantly predictive of decreased mortality.

Accidents↗
PubMed2005

Childhood adversities and health variations among middle-aged men: a retrospective lifecourse study.

BACKGROUND: Using a lifecourse approach, this study examines whether childhood adversities act on adult health as latent or pathway effects, and whether not only childhood ill health and material deprivation, but also an adverse psychosocial environment in terms of stressful relations with parents contribute to later ill health. METHODS: Lifecourse interviews with 380 men born in 1946 were conducted. Outcome variables were perceived health, number of medical conditions, and activity limitations. Ordinal scales indicating levels of exposures as regards childhood health/growth, childhood material deprivation, stressful relations with parents, educational level, and unhealthy adult behaviours were made. Statistical analyses were performed by non-parametric correlation, logistic regression and OLS regression with dummy variables. RESULTS: Simple regression analyses showed a consistent pattern of more negative health outcomes with higher exposures on each of the lifecourse health determinants, but associations were relatively often not statistically significant. In multivariate analyses, the overall pattern remained with few alterations. The lifecourse determinants differed somewhat in their effects on the three health outcomes. Stressful relations with parents were significantly associated with perceived health and activity limitations. CONCLUSIONS: Childhood adversities influence later health to a large extent as latent effects. Stressful relations with parents were relatively important for two of the health outcomes, suggesting that not only ill health and material deprivation during childhood, but also an adverse psychosocial environment contributes to ill health among middle-aged men. KEY POINTS: The study asks whether childhood adversities influence middle-aged men's health through latent or pathway effects. Adjusted for adult circumstances, childhood health problems were associated with activity limitations and medical problems among men aged 55. Stressful relations to parents during childhood had direct negative effects on perceived overall health and activity limitations. Results indicate that childhood adversities often affect adult health as latent effects. Health promotion policies should consider that childhood psychosocial difficulties may have longterm negative health consequences.

Age of Onset↗
PubMed2005

The causes of homelessness in later life: findings from a 3-nation study.

OBJECTIVE: This article presents findings from a study of the causes of homelessness among newly homeless older people in selected urban areas of the United States, England, and Australia. METHODS: Interviews were conducted in each country with > or =122 older people who had become homeless during the last 2 years. Information was also collected from the subjects' key workers about the circumstances and problems that contributed to homelessness. RESULT: Two-thirds of the subjects had never been homeless before. Antecedent causes were the accommodation was sold or needed repair, rent arrears, death of a close relative, relationship breakdown, and disputes with other tenants and neighbors. Contributory factors were physical and mental health problems, alcohol abuse, and gambling problems. DISCUSSION: Most subjects became homeless through a combination of personal problems and incapacities, welfare policy gaps, and service delivery deficiencies. Whereas there are nation-specific variations, across the three countries, the principal causes and their interactions are similar.

Adult↗
PubMed1981

Life stress and dimensions of functioning in old age.

The present investigation studied the current life adjustment and social and physical activity patterns of a group of 96 elderly men (mean age = 77) who had been initially evaluated 30 years previously. The dimension of functioning of this group in old age also were delineated. A second focus of the investigation was an evaluation of the effect of past personality and current life stresses on present adjustment. Five dimensions of functioning in old age were identified: these were labeled Neuroticism, Somatic Concern, Alienation, Introversion, and Passivity. The Somatic Concern factor was associated with reported physical illness. Current physical illness was also related to relative elevations on the current MMPI Hs scale score; death of a close one was related to relative elevations in score on the current MMPI Si scale. Past personality interacting with current life stresses was not predictive of present personality functioning.

Aged↗
PubMed1994

The relationship between retirement life cycle changes and older men's labor force participation rates.

This study probes the utility of older men's labor force participation rates (LFPRs) as indicators of the work-to-retirement transition. Specific attention is directed at how shifts in the retirement life cycle are related to LFPRs. Based on Current Population Survey data for the 1970s, a life table modeling approach showed that LFPRs are relatively weak indicators of the work-to-retirement transition. This was demonstrated by the relative stability in older men's age profiles of LFPRs despite significant changes in the timing and "organization" of the work-to-retirement transition. The 1970s evidenced a contraction of the main career and the expansion of both post-retirement work activity and retirement, yet none of these changes substantially altered the age profiles of older men's labor force participation rates.

Aged↗
PubMed1993

The romance with personal meaning in gerontology: cultural aspects of life themes.

Life narratives have wide appeal because they promote the modern ideal of freeing people to reflect on their life and to share personal meanings and experience in public. Constructing a life story may aid adult development and well-being. This article explores how to enhance these benefits, but criticizes the idealization of stories and their benefits. Using life stories from 16 randomly selected clinically depressed and nondepressed elderly persons, this article examines the narrative structures and how these relate to mood and to ideal images for the self. Findings show that some normative styles for self-representation (i.e., personal themes) serve to express distress instead of positive well-being. The discussion points to cultural and historical forces shaping our ideas about themes in stories. Life stories do privilege personal meanings, but the settings and form constrain their value as research data and their effectiveness as vehicles for enhancing well-being.

Affect↗
PubMed1989

Characteristics of past smokers.

We studied characteristics of past smokers according to the duration of cessation of smoking based on data from a population-based survey. Lifestyle, prevalences of various symptoms and diseases and other factors were compared among current smokers (8507 males and 2012 females), past smokers (4423 males and 684 females) and non-smokers (2431 males and 12,859 females) aged 40 years and over. Compared to current smokers, past smokers consumed more bread, milk, vegetables, fruit and black tea, and less rice, pickles, instant noodles, coffee and alcohol, had lower prevalences of cough, sputum and anorexia, participated more in cancer screening tests, weighed more, included more professional and administrative workers and had more non-smoking spouses. These characteristics resembled those of non-smokers. But past smokers had high prevalences of several cardiovascular and respiratory diseases compared to current smokers. Daily intake of coffee was inversely associated and daily intakes of fruit and milk were positively associated with the duration of abstinence from smoking after adjusting for other factors in both sexes. These results suggest that lifestyle of past smokers may contribute to risk reduction for several diseases.

Adult↗