Biomedical subjects

A B Kornblith

Publications and source records attributed to A B Kornblith.

47 records · Page 3Linked to original sources

PubMed1990

Quality of life assessment of Hodgkin's disease survivors: a model for cooperative clinical trials.

With the growing number of patients surviving cancer, there has been an increasing concern with their long-term adaptation. Given the large number of Hodgkin's disease survivors, it was possible to conduct a study of their psychosocial adaptation. Two hundred seventy-three survivors of advanced Hodgkin's disease were interviewed over the telephone concerning the impact of cancer upon their lives, in terms of their psychological, social, and sexual functioning. The level of psychological distress was elevated by one standard deviation above normal on the Brief Symptom Inventory (BSI), for both men and women. Survivors in greater distress reported more problems in other areas of functioning, including sexual, social, vocational, and persistent conditioned nausea.

Adaptation, Psychological↗

PubMed1990

Changes in 31P nuclear magnetic resonance with tumor growth in radioresistant and radiosensitive tumors.

In vivo 31P nuclear magnetic resonance (31P NMR) spectroscopy has been used to compare metabolic profiles with tumor radiosensitivity. A radioresistant mammary carcinoma (MCa) and a radiosensitive methylcholanthrene-induced fibrosarcoma (Meth-A) were studied by 31P NMR spectroscopy in the tumor volume range of approximately 100-1200 mm3. The MCa showed a constant pH in this volume range; the ratio of phosphocreatine to inorganic phosphate (PCr/Pi) for 160-300 mm3 tumors was 0.33 +/- 0.11 (mean +/- standard deviation) and did not change (0.29 +/- .09) for tumors in the volume range of 600-1200 mm3. In comparison, the Meth-A showed a decrease in tumor pH as volume increased from 160-300 mm3 (pH 7.16 +/- 0.4) to 600-1200 mm3 (pH 6.94 +/- .07). Tumor PCr/Pi decreased from 0.70 +/- .16 (160-300 mm3) to 0.33 +/- .16 (600-1200 mm3). The radiation doses for control of MCa-induced tumors in 50% of the treated tumors ranged from 65 (150-250 mm3) to 71 Gy (1000-1300 mm3) and for the Meth-A-induced tumors ranged from 35 (150-250 mm3) to 38 Gy (1000-1300 mm3). These results suggest that 31P NMR spectra may be a qualitative predictor of tumor hypoxia, although further studies of human and rodent tumors are necessary to support this hypothesis.

Animals↗

PubMed1986

Employment in individuals with multiple sclerosis.

The major objectives of this research were to examine unemployment in the MS population on a national level, and to identify factors which might influence an MS individual's employment status. Data used were from the National Multiple Sclerosis Survey conducted by the National Institute of Neurological and Communicative Disorders and Stroke. Data analysis was restricted to a subset of the sample who had worked at some time in their lives. Of 949 persons 79.7% were currently unemployed. While 65.2% had worked at the time of first symptom, only 27.2% were working at the time of the interview, an average of 17 years later. Path analyses revealed the overwhelming importance of mobility for remaining employed, particularly for males. Additional differences found between male and female path models were interpreted in terms of social role theory.

Disability Evaluation↗

PubMed1986

Measurement technology applications in performance appraisal.

Every nursing administrator needs a credible performance appraisal system. By using psychometric methods and computer technology, the process of developing such a system can be more efficient and demonstrably successful. This article raises issues that relate to changing the performance appraisal system and gives a clear, step-by-step description of how computerized, statistical procedures were applied in improving nursing performance appraisal.

Computers↗

PubMed1981

Multiple drug abuse involving nonopiate, nonalcoholic substances. I. Prevalence.

A review of the literature on multiple drug abuse involving two or more drug categories, where at least one is a nonopiate, nonalcoholic substance (MDA-NONA), revealed that Whites and, to a lesser extent, females are overly represented, disproportionate to their composition in other patterns of drug use. In addition, there is evidence that MDA-NONA abusers are very psychologically disturbed and sociopathically deviant, although it has not been established that their clinical picture is worse than that presented by other drug populations. Theoretical frameworks are presented in an attempt to explain these epidemiological findings.

Alcoholism↗

PubMed1981

Multiple drug abuse involving nonopiate, nonalcoholic substances. II. Physical damage, long-term psychological effects and treatment approaches and success.

A review of the literature of multiple drug abuse involving two or more drug categories where at least one is a nonopiate, nonalcoholic substance (MDA NONA) suggested the possibility that sedative-hypnotics were the culpable agent for neuropsychological deficits in this group. Individually, amphetamines and hallucinogens, primarily LSD, have been associated with long-term psychological disturbance. While many abusers of these drugs who develop psychoses have been documented to be emotionally disturbed prior to drug usage, indicating that the drug exacerbated a prepsychotic condition, other abusers have no such history, indicating a drug-induced psychosis. Current treatment approaches appear to be ineffective for MDA-NONA abusers, as indicated by poor retention rates and relapse to drug use.

Amphetamines↗

PubMedDate not supplied

Quality of life of maxillectomy patients using an obturator prosthesis.

BACKGROUND: The psychosocial adaptation of patients who had undergone a resection of the maxilla for cancer of the maxillary antrum and/or hard palate with the placement of an obturator prosthesis to restore speech and eating function was studied. METHODS: Forty-seven patients were interviewed who had a maxillectomy with an obturator prosthesis at Memorial Sloan-Kettering Cancer Center, an average of 5.2 years (SD = 2.4 years) ago, 94% of whom had some of their soft palate resected. Interviews were conducted by telephone by a trained research interviewer, using a series of questionnaires to assess their satisfaction with the functioning of their obturator, and the psychological, vocational, family, social, and sexual adjustment. Measures included the Obturator Functioning Scale (OFS). Psychosocial Adjustment to Illness Scale (PAIS), Mental Health Inventory (MHI), Impact of Event Scale, and Family Functioning Scale. RESULTS: Using multiple regression and discriminant function analyses, satisfactory functioning of the obturator prosthesis, as measured by the OFS, was found to be (1) the most highly significant predictor of adjustment, as measured by the PAIS (p < .0001) and the MHI Global Psychological Distress Subscale (MHI-GPD) (p < .001), and (2) significantly related to their perception of the negative socioeconomic impact of cancer upon their lives. The most significant predictor of better obturator functioning were the extent of resection of their soft palate (one third or less, p < .001), and hard palate (one fourth or less, p < .01). Specific aspects of obturator functioning that most significantly correlated with better adjustment (PAIS, MHI-GPD) were: less difficulty in pronouncing words (r = .40 and r = .51, respectively, p < .01), chewing and swallowing food (r = .27-.46, p < .05), and less change in their voice quality after surgery (r = .52 and r = .56, respectively, p < .001). CONCLUSIONS: These findings suggest that a well-functioning obturator significantly contributes to improving the quality of life of maxillectomy patients.

Adaptation, Psychological↗

PubMedDate not supplied

A pilot study of interpersonal psychotherapy by telephone with cancer patients and their partners.

A single-arm pilot study explored the feasibility of adapting in Interpersonal Psychotherapy (IPT) by telephone to reduce psychological distress and to enhance coping during cancer treatment. Therapy focuses on role transitions, interpersonal conflicts, and grief precipitated by cancer. Breast cancer patients receiving high-dose chemotherapy received weekly sessions with a psychologist throughout chemotherapy and for 1 month afterwards. Patients could invite one 'partner' to receive individual telephone IPT. Psychosocial functioning was assessed using standardized measures at study entry, after chemotherapy, and following telephone IPT. Accrual and participation supplied evidence of feasibility: 14 patients and 10 partners were recruited, 82.5% of those eligible. Patients had a mean of 16 sessions; partners had a mean of 11. Participants rated their satisfaction with the program between 'good' and 'excellent'. A test of the efficacy of telephone IPT requires a larger, randomized trial. In order to standardize the intervention, a treatment manual was developed. This study indicated the importance of outreach to family members as well as to cancer patients, intensive patient education about oncology treatment and the medical care setting, and psychosocial services that continue after cancer treatment has been completed.

Adaptation, Psychological↗

PubMedDate not supplied

Involving family members in cancer care: focus group considerations of patients and oncological providers.

Family members are an integral part of a patient's cancer care from the moment the diagnosis is delivered to the conclusion of treatment. Family members bring with them a range of emotional reactions, interpersonal dynamics and expectations for the care the patient receives. This study is part of a multi-institutional project to continue to improve the process of cancer care. In this study, 19 focus groups (11 patient and 8 provider) were conducted concerning issues related to doctor-patient communication in eight cancer centers in the United States. The content of the conversations was analyzed and thematic categories emerged that highlight the various strengths and difficulties associated with family involvement. The focus groups' comments support the need for explicit conversations between professional caregivers, patients and their loved ones, in order to negotiate the expectations and needs of each team member. Implications for clinical practice and strategies for working with family members are offered.

Adaptation, Psychological↗

PubMedDate not supplied

Art therapy with adult bone marrow transplant patients in isolation: a pilot study.

Psycho-social interventions for cancer patients in isolation for bone marrow transplant (BMT) have been advocated in the recent literature. It is not clear what type of interventions would be most appropriate. This study was conducted at Memorial Sloan-Kettering Cancer Center (MSKCC), with three aims. (1) To test the feasibility of introducing art therapy as a supportive intervention for adult BMT patients in isolation. Nine patients were seen in art therapy sessions twice a week while in isolation, and were helped to develop free personal images. The three art therapists used the same art therapy program as a model. (2) To assess how patients would use the program. Forty-two images were made by the nine patients during the art therapy sessions. A thematic analysis of the images showed that the patients used art therapy effectively in three ways: (a) to strengthen their positive feelings, (b) to alleviate their distress, and (c) to clarify their existential/spiritual issues. (3) The third aim was to identify which patients would most benefit from art therapy. Our results suggest that the non-verbal metaphorical modality of art therapy may be especially beneficial for patients who need to deal with emotional conflicts, and with feelings about life and death, in a safe setting.

Adult↗

PubMedDate not supplied

Supportive telephone intervention for patients receiving chemotherapy. A pilot study.

Psychosocial interventions have been shown to improve quality of life (QOL) for many cancer patients. A pilot study was conducted to assess the feasibility of a psychoeducational intervention for cancer patients receiving chemotherapy. Eight patients receiving chemotherapy for colorectal carcinoma participated. The intervention is based on a modification of Interpersonal Therapy. It consisted of four sessions, administered biweekly, using a manual format, by a psychiatric nurse clinician over the telephone. The participants also completed a set of QOL measures by telephone to assess tolerance of the planned assessment. The patients received assistance with treatment-related side effects, reported improved ability to communicate with their physician, and gained an understanding of the stresses they discussed. The patients felt satisfied with the emotional support and medical information provided. A randomized trial is planned to test the intervention for patients participating in a cooperative trial sponsored by the National Cancer Institute.

Aged↗