ABSTRACT
The purpose of the current study was to examine the impact of massage therapy on psychological, physical, and psychophysiological measures in patients undergoing autologous bone marrow transplantation (BMT). Patients scheduled to undergo BMT were randomly assigned to receive either (a) massage therapy, consisting of 20-minute sessions of shoulder, neck, head, and facial massage, or (b) standard treatment. Overall effects of massage therapy on anxiety, depression, and mood were assessed pretreatment, midtreatment, and prior to discharge using the State-Trait Anxiety Inventory, Beck Depression Inventory, and Brief Profile of Mood States, respectively. The immediate effects of massage were measured via the State Anxiety Inventory, Numerical Scales of Distress, Fatigue, Nausea, and Pain and indices of psychophysiological arousal (heart rate, blood pressure, and respiration rate), collected prior to and following patients' first, fifth, and final massage (on Days--7, midtreatment, and predischarge). Analysis of the data evaluating the immediate effects of massage showed that patients in the massage therapy group demonstrated significantly larger reductions in distress, fatigue, nausea, and State Anxiety than the standard treatment group at Day-7, in State Anxiety at midtreatment, and in fatigue at the predischarge assessment. The overall measures of psychological symptoms measured at pretreatment, midtreatment, and prior to discharge showed no overall group differences, although the massage group scored significantly lower on the State Anxiety Inventory than the standard care group at the midtreatment assessment. The two groups together showed significant declines through time on scores from the Profile of Mood States and State and Trait Anxiety Inventories.
Subject(s)
Bone Marrow Transplantation/adverse effects , Massage , Stress, Psychological/therapy , Adult , Affect , Female , Humans , Male , Psychiatric Status Rating Scales , Stress, Psychological/etiology , Stress, Psychological/psychologyABSTRACT
PURPOSE: The major purpose of the current study was to evaluate the psychologic and neuropsychologic functioning of patients undergoing treatment with autologous bone marrow transplantation (ABMT). PATIENTS AND METHODS: Fifty-four patients with hematologic disorders or breast cancer completed a battery of psychologic and neuropsychologic tests before ABMT, at mid-treatment (1 to 3 days following bone marrow reinfusion), and predischarge (within 1 to 2 days before discharge from the hospital). RESULTS: Analysis of pretransplant data showed significantly higher scores on the State-Trait Anxiety Inventory (STAI) and Profile of Mood States (POMS) for patients with hematologic disorders as compared with patients with breast cancer. However, no baseline differences on neuropsychologic measures were found when patients were divided into groups based on prior exposure to cranial radiation and/or intrathecal chemotherapy. Serial evaluations at pretransplant, following return of bone marrow, and at predischarge were available for 34 patients. For the psychologic data, patients with hematologic disorders tended to be more distressed than breast cancer patients at baseline, but became less distressed over time. By contrast, breast cancer patients were relatively less distressed at baseline, demonstrated a significant increase in distress midtreatment, and returned to baseline levels at predischarge assessment. Scores on neuropsychologic measures that assessed higher order cognitive functioning generally worsened over time. CONCLUSION: The results suggest a differential response on psychologic measures when comparing patients with hematologic disorders with those with breast cancer. However, both groups demonstrated a general decline in performance on neuropsychologic measures over the course of treatment.
Subject(s)
Bone Marrow Transplantation/psychology , Breast Neoplasms/psychology , Hodgkin Disease/psychology , Leukemia, Myeloid, Acute/psychology , Lymphoma, Non-Hodgkin/psychology , Adult , Affect , Aged , Analysis of Variance , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Anxiety , Breast Neoplasms/therapy , Combined Modality Therapy , Female , Hodgkin Disease/therapy , Humans , Leukemia, Myeloid, Acute/therapy , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Neuropsychological Tests , Prospective StudiesABSTRACT
Sixty cancer chemotherapy patients were randomly assigned to one of six conditions formed by a 3(cognitive distraction, relaxation training, no intervention) x 2(high anxiety, low anxiety) factorial design. All patients were followed for five consecutive chemotherapy sessions. Outcome measures included patient reports, nurse observations, and physiological indices. Results indicated that distraction patients reported less nausea prior to chemotherapy and lower systolic blood pressures after chemotherapy than controls. Relaxation training patients reported less nausea prior to chemotherapy and exhibited lower systolic and diastolic blood pressures after chemotherapy than control patients. There were no significant differences between distraction and relaxation training patients on any measure. Patients with high initial levels of anxiety exhibited continually elevated levels of distress throughout the chemotherapy experience; however, anxiety level did not interact with the effectiveness of the treatment interventions. Overall, the data support the use of both cognitive distraction and relaxation training for reducing the distress of chemotherapy with both high and low-anxiety patients and suggest that at least some of the effects of relaxation training can be achieved with distraction alone.
Subject(s)
Antineoplastic Agents/adverse effects , Attention , Cognitive Behavioral Therapy , Neoplasms/drug therapy , Relaxation Therapy , Vomiting, Anticipatory/therapy , Adult , Aged , Antineoplastic Agents/therapeutic use , Anxiety/psychology , Anxiety/therapy , Female , Humans , Male , Middle Aged , Muscle Relaxation , Neoplasms/psychology , Personality Assessment , Play and Playthings , Vomiting, Anticipatory/psychologyABSTRACT
This review deals with the issues of quality of life and psychological well-being in cancer patients, with particular reference to the role of psychiatry in the oncology setting. The prevalence of psychiatric diagnoses as a measure of psychological well-being, the prediction of psychological well-being, the interactions between physical and psychological factors, and the impact of psychosomatic intervention on quality of life in cancer patients, are discussed.
Subject(s)
Neoplasms/psychology , Psychophysiologic Disorders/psychology , Quality of Life , Sick Role , Adaptation, Psychological , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Depressive Disorder/psychology , Depressive Disorder/therapy , Humans , Neoplasms/therapy , Neurocognitive Disorders/psychology , Neurocognitive Disorders/therapy , Patient Care Team , Psychophysiologic Disorders/therapyABSTRACT
Cancer patients receiving chemotherapeutic treatments often experience unpleasant side effects that compromise the quality of their life and may be so severe that they lead to suboptimal drug dosages, missed treatments, or even discontinuation of treatment. In recent years it has been discovered that some of these side effects result from maladaptive learning. This article reviews over 10 years of research conducted at Vanderbilt University on the prevention and treatment of these psychological side effects. This research includes the assessment of the efficacy of a behavioral relaxation technique, the exploration of procedures that make this intervention clinically practical for widespread application, research aimed at predicting which patients will and will not benefit from the intervention, and the comparison of this intervention to alternative treatment approaches. The review of this research generates four major conclusions and points to several important areas for future inquiry.
