ABSTRACT
Breast cancer is the most common neoplasm in occidental women, yet very little information is available about the rehabilitation needs of these patients. This report reviews in detail the physical, psychological, social, and financial problems identified by fifty women during the first month after primary surgical treatment. The most frequently reported problems were physical and psychological. Patients undergoing modified radical mastectomy (MRM) are compared with patients receiving segmental mastectomy and primary radiotherapy (SM). There were few differences between the two surgical treatment groups; however, patients in the MRM group reported more difficulty with clothing and body image, while the SM group had more disruption of recreation and social activities. Information about the rehabilitation problems of patients with this common neoplasm should be helpful to patients and to the members of the health care team who are helping them recover.
Subject(s)
Breast Neoplasms/rehabilitation , Postoperative Care/psychology , Adult , Aged , Breast Neoplasms/therapy , Combined Modality Therapy , Female , Humans , Marriage , Mastectomy/methods , Mastectomy/rehabilitation , Middle Aged , Surveys and Questionnaires , Time FactorsSubject(s)
Marital Therapy/methods , Neoplasms/psychology , Physical Exertion , Psychotherapy, Group/methods , Adaptation, Psychological , Adult , Aged , Combined Modality Therapy , Female , Humans , Male , Middle AgedABSTRACT
This report examines the psychosocial impact of cancer in 240 men according to age using a recently developed cancer-specific survey instrument. Overall, younger patients experienced more frequent or severe psychosocial and treatment-related problems than the older patients, especially in relation to work and chemotherapy. In addition, younger patients experienced more difficulty dealing with the health care setting. The authors conclude that the elderly cancer patient experiences less psychosocial disruption from cancer than do younger individuals.
Subject(s)
Neoplasms/psychology , Activities of Daily Living , Adaptation, Psychological , Adult , Age Factors , Aged , Attitude to Death , Attitude to Health , Chronic Disease/psychology , Communication , Decision Making , Humans , Male , Marriage , Middle Aged , Neoplasms/therapy , Patient Compliance , Sexual Behavior , Social AdjustmentABSTRACT
With the recent improvement in cancer therapy, patients are living for extended periods of time. There is little information on the day-to-day problems that these patients experience. The paucity of such information is due to the absence of instruments specifically designed to document these problems. The authors have developed an instrument, The Cancer Inventory of Problem Situations (CIPS), and present a study of 84 cancer patients using the CIPS. Preliminary evaluation of the instrument in this small and heterogeneous group of patients demonstrates that cancer has a significant, extensive impact on psychosocial and physical functioning. Cancer patients have moderate to severe problems in personal care, activity management, involvement with the health care system, work, and interpersonal interactions.
Subject(s)
Adaptation, Psychological , Neoplasms/psychology , Problem Solving , Psychological Tests , Activities of Daily Living , Adult , Female , Humans , Interpersonal Relations , Male , Middle Aged , Psychometrics , Sick Role , Social AdjustmentABSTRACT
Little research has been conducted documenting the reliability and validity of the Karnofsky Performance Status (KPS) scale, and guidelines based on empirical data do not exist to govern its use. Two hundred ninety-three cancer patients completed a questionnaire that assesses their physical and psychosocial difficulties. Physicians rated patients on the KPS and a subsample of 75 patients was used to evaluate interrater reliability. Analyses were conducted to evaluate the interrater reliability and construct validity of the KPS. The KPS was shown to have good reliability and validity. Detailed examination of the reliability data suggested areas in which physicians err in their judgments. Multiple regression techniques were used to empirically identify seven behaviorally based questions that would be helpful in predicting KPS scores. The seven variables included weight loss, weight gain, reduced energy, difficulty walking, driving, grooming, and working part time. An interview approach with behaviorally based guidelines is presented using these variables to obtain relevant data and make more accurate KPS ratings. With the approach suggested and the guidelines presented, oncologists may train themselves to use the KPS in a standard way, which should increase reliability and validity of the KPS and has implications for patients and research studies that use KPS as a stratifying variable.
Subject(s)
Activities of Daily Living , Disability Evaluation , Neoplasms , Female , Humans , Male , Middle Aged , Neoplasms/rehabilitation , Prognosis , Regression Analysis , Self-Assessment , Surveys and QuestionnairesABSTRACT
Two studies are presented which describe the development of a problem-oriented psychosocial screening instrument for use in health care settings. Reliability and validity data are presented on the Chronic Illness Problem Inventory (CIPI) which demonstrate its ability to document accurately patient's specific problems in areas of physical limitations, psychosocial functioning, health care behaviors and marital adjustment. A study is also presented which compares the problems of patients with three distinct chronic illnesses: pain, obesity, and respiratory ailments. Results indicate a significantly greater severity of problems for pain patients and especially patients with multiple pain complaints. Problem areas common to all three illness groups are discussed in the context of providing better comprehensive treatment for chronically ill patients.
