Life after cancer: couples' and partners' psychological adjustment and supportive care needs.

GOALS OF WORK: Partners of cancer patients may experience significant distress at the time of treatment and many may experience persistent difficulties, although little research has examined their longer term psychosocial outcomes or supportive care needs. MATERIALS AND METHODS: One hundred and fifty-four cancer survivors who were 1-11 years post diagnosis and disease-free and their partners completed mailed questionnaires. MAIN RESULTS: A positive relationship was found between psychological distress and supportive care needs both within and between partner and survivor samples. Partners reported high levels of anxiety and supportive care needs, most frequently concerning relationships and the impact of the cancer illness. Partners within couples reported both shared and unique needs, although agreement on ratings of shared needs was low. Needs did not diminish over time although partners demonstrated psychological resilience and reported positive outcomes. Predictors of distress and unmet needs were explored: physical QOL, relationship satisfaction, and total needs contributed to variability in partners' distress; relationship satisfaction and total needs were associated with survivors' distress. Distress and relationship satisfaction were associated with partners' unmet needs; only distress was associated with survivors' unmet needs. CONCLUSIONS: Partners are not merely providers of support, but need support themselves many years after a cancer diagnosis and in the context of apparently cured disease. The quality of the dyadic relationship may be critical in determining both partner and survivor distress and needs, and may prove a useful target for psychosocial interventions.

Assessing unmet supportive care needs in partners of cancer survivors: the development and evaluation of the Cancer Survivors' Partners Unmet Needs measure (CaSPUN).

BACKGROUND: Partners of cancer patients typically provide the majority of patients' emotional and physical care. Partners may be profoundly affected by the cancer and may experience ongoing supportive care needs across the survivorship continuum. Research has been restricted by a lack of psychometrically evaluated measures and in this study, a self-report measure of partners' needs was developed and empirically evaluated. METHODS: Questionnaire items generated from a qualitative study were constructed into a 47- item unmet need measure (Cancer Survivors' Partners Unmet Needs measure, CaSPUN). The psychometric properties of the CaSPUN were evaluated in 212 partners of patients who had been diagnosed with cancer 1-11 years earlier and were currently disease-free. RESULTS: The CaSPUN was modified to include 35 unmet need items, 6 positive change items and an open ended item. The CaSPUN demonstrates a high level of acceptability, internal consistency and construct validity, although test-retest reliability was moderate. Factor analysis identified five discrete factors: (1) Relationships, (2) Information, (3) Partner Issues, (4) Comprehensive Care and (5) Emotional Support. CONCLUSIONS: The CaSPUN permits the identification of long-term supportive care needs in generic populations of cancer survivors' partners and will assist with the formulation of recommendations regarding required supportive care services.

The development and evaluation of a measure to assess cancer survivors' unmet supportive care needs: the CaSUN (Cancer Survivors' Unmet Needs measure).

BACKGROUND: Many cancer survivors experience ongoing morbidity over the survivorship continuum and their supportive care needs have yet to be comprehensively assessed. METHODS: This study aimed to develop and empirically evaluate a self-report measure of cancer survivors' supportive care needs. In Phase I, questionnaire items were generated based upon previous qualitative research that identified both unique and shared needs in survivors and their partners; items were constructed into the Cancer Survivors' Unmet Needs measure (CaSUN). In Phase 2, the CaSUN was completed by 353 cancer survivors who had been diagnosed with cancer between 1 and 15 years earlier and were currently disease-free. RESULTS: After modification, the CaSUN included 35 unmet need items, 6 positive change items and an open-ended question. Good acceptability, internal consistency and validity were demonstrated, although test-retest reliability was low. Maximum likelihood factor analysis identified five discrete factors: Existential Survivorship, Comprehensive Care, Information, Quality of Life and Relationships. CONCLUSIONS: Preliminary data indicates that the CaSUN meets the majority of psychometric criteria for assessment measures, although its low test-retest reliability awaits further investigation. The CaSUN will facilitate the evaluation of supportive care services and generation of service delivery recommendations for cancer survivors.

Automated measurement of dye coverage in photographic negatives by flow-injection analysis.

A system was designed to automate the determination of three image dyes in an instant photographic material. The method involves extracting negative samples with dimethylsulfoxide and filtering the extract, followed by quantitating the dye coverage (dye per unit area of negative) through a spectrophotometric flow-injection procedure. Significant spectral overlap exists among the dyes, and as a result calculation of coverage requires solving three simultaneous equations. A microcomputer and data acquisition system were employed for controlling the detector and flow-injection system, acquiring and integrating the detector response, calculating coverage, producing and displaying control charts, and automatically transferring results to a VAX based corporate database. In addition to automating sample preparation and measurement steps as much as possible, the goal of this project was to automate the data manipulation and transfer steps.

Studies on antibody levels to Brucella abortus, Toxoplasma gondii and Leptospira serogroups in sera collected by the National Serum Bank during 1974-1976.

The New Zealand National Serum Bank is a collection of human sera consisting predominantly of specimens taken from healthy New Zealand blood donors. The studies presented here were designed to assess the antibody levels in two urban centres to Brucella abortus, Toxoplasma gondii and several Leptospiral serogroups including all those found in New Zealand. In none of the sera could complement fixing leptospiral antibodies be detected. There was evidence of low level immunity to both Toxoplasma gondii and Brucella abortus.

Investigation into the immunoglobulin class responsible for the polar staining of Toxoplasma gondii in the fluorescent antibody test.

Bipolar staining of the trophozoites of Toxoplasma gondii has been observed with a number of sera from patients. It has been demonstrated that the serum factors involved are IgM. The majority of sera demonstrating this phenomenon had raised nonspecific IgM levels.