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Biomedical subjects

A Bottomley

Publications and source records attributed to A Bottomley.

35 records · Page 2Linked to original sources
PubMed2002

Health related quality of life assessment methodology and reported outcomes in randomised controlled trials of primary brain cancer patients.

Over the last 20 years, the assessment of quality of life (QOL) has become an important endpoint in cancer clinical trials, helping us to understand patient survival and QOL experiences and aiding clinicians in providing the best possible treatment and care, with the least toxicity and ill-effects. In primary brain cancer, these are critical issues. Survival is often limited and treatment difficult to tolerate. In recent years, some authors have questioned the methodological quality of the investigations and the reporting of QOL assessments from randomised controlled trials (RCTs), of cancer patients yet this assessment has never specifically focused on brain cancer. This paper therefore reports a systematic review of the research methodology and QOL assessment reporting in brain cancer patients in RCTs. The search was mainly performed on the following databases: Medline, Cancerlit and the Cochrane Controlled Trials Register. We identified only five RCTs, enrolling a total of 1026 patients. In many of these studies, we had identified methodological limitations which would hinder the interpretation of the results. These included a lack of detailed reporting regarding missing data, use of poorly validated tools, and general limitations regarding the presentation and interpretation of the results. Based on the results of our review, we make recommendations for future investigations to avoid these shortcomings.

Brain Neoplasms↗
PubMed2000

Quality of life evaluation in oncological clinical trials - the EORTC model. The EORTC Quality of Life Study Group.

The European Organization for Research and Treatment of Cancer (EORTC) has taken a leading role in the development of the methodology of quality of life (QL) measurement. In the EORTC Quality of Life Study Group (QLSG) valid instruments to assess QL in a general manner and disease-specific modules have been developed to be used in oncological clinical trials. Statistical and methodological aspects of QL research are discussed. The application of QL assessments in clinical trials represents a subsequent challenge. To improve the practice of QL assessment in clinical trials an 'EORTC model' has been developed. This model requires the collaboration of liaison persons, the EORTC Cooperative Tumour Groups and the EORTC Data Centre Quality of Life Unit (QL Unit). Cooperation between these parties, protocol development and advantages and concerns of the model are mentioned in this paper. Finally, suggestions for improvement are proposed.

Clinical Protocols↗
PubMed1998

Group cognitive behavioural therapy with cancer patients: the views of women participants on a short-term intervention.

At present many emotionally distressed cancer patients receive no psychological intervention. The aim of this paper is to examine and report qualitatively on the experiences of a small group of seven newly diagnosed women who underwent a group cognitive behavioural therapy (GCBT) programme. The GCBT programme was part of a larger piece of research comparing patients' experiences of GCBT with that of group social support or no group programme of support. Following the 8-week GCBT programme, qualitative analysis of interview data revealed that patients had learned the skills required to challenge and solve problems and to use the cognitive model and effectively employ behavioural exercises to generate improved coping. The results also suggest that a GCBT programme with newly diagnosed cancer patients may need to allow cancer patients considerable opportunities to ventilate feelings and engage in social support with other patients, this being regarded as a highly valuable component to build into a GCBT programme.

Adaptation, Psychological↗
PubMed1998

Psychotherapy groups and cancer patient survival: chasing fool's gold?

Increasingly, clinicians are reading literature concerning group interventions that examine group influences on the emotional well-being and survival of cancer patients. This article focuses on reviewing the literature of randomized controlled trials (RCT) reported to examine survival rates among cancer patients involved in group interventions; it highlights some of the limitations seen in these past studies and suggests issues that researchers may need to consider in the future.

Humans↗
PubMed1998

Depression in cancer patients: a literature review.

It is estimated that 20-25% of cancer patients suffer often unrecognized and untreated long-term depression, a condition that can make life miserable. Symptoms can include: lack of sleep; loss of interest in life; anxiety; irritation; loss of concentration; and, in severe cases, thoughts of suicide; leading to an overall poor quality of life. Given that the majority of patients diagnosed with clinical depression can be effectively treated with one form of treatment or another (psychological, pharmacological or a combination) it is now important that health care professionals routinely assess and offer treatment for depression in cancer patients. Therefore, this article reviews the literature on depression caused by cancer and highlights practical ways in which health care workers can measure and subsequently treat depression using pharmacological and psychological approaches.

Antidepressive Agents↗
PubMed1998

Anxiety and the adult cancer patient.

While anxiety is a common psychological symptom in cancer patients, unfortunately, few patients are diagnosed or even treated for the symptoms that can occur due to the debilitating nature of anxiety. These can even lead to patients not following the best medical care to ensure they have the fullest chance of recovery. The following article discusses some of the anxiety related problems health care workers see in patients with cancer, and suggests ways to identify and treat patients with these anxiety disorders.

Adaptation, Psychological↗
PubMed1998

Providing psycho-social support by telephone: what is its potential in cancer patients?

This paper provides an overview of the use of supportive telephone interventions in cancer patients. The small number of studies that have been reported to date have demonstrated that such approaches are feasible and well accepted. Current telephone counselling programmes for cancer patients have utilized both one-to-one and group approaches. Given the promise of telephone interventions to provide assistance to patients who may not otherwise receive psycho-social care because of factors such as geographical isolation, physical limitations, or lack of comfort with face-to-face approaches, further development and evaluation of programmes in this area is critically needed. We identify priorities for future research, including determining the most effective ways to deliver telephone interventions, identifying patient groups in which they are most successful, and evaluating cost-effectiveness.

Counseling↗
PubMed1997

Breast cancer care: women's experience.

Medical treatments for breast cancer are undergoing rapid change. Studies of the management of breast cancer have investigated the psychosocial consequences of the diagnosis as expressed by the patients themselves, but infrequently relate these women's views directly to improvements in health care systems. The following study explores the experience of 18 women recently diagnosed as having breast cancer. The findings illustrate to both clinicians and managers the importance of considering a number of dimensions relevant to the psychosocial care of patients and suggest areas where health care systems may be modified to address the psychosocial needs of women. The results demonstrate the positive impact patient views can have on the development of health care services.

Adolescent↗
PubMed1997

To randomise or not to randomise: methodological pitfalls of the RCT design in psychosocial intervention studies.

We are seeing evidence of more studies investigating the effectiveness of psychosocial interventions of cancer patients, predominantly within groups. As roles within cancer and palliative care diversify, specially trained nurses and other health care workers are taking a more active role within psychosocial intervention studies. Frequently, these studies are randomised controlled trials (RCTs). Often, the results of these psychosocial RCTs have been laid open to general criticisms of design, implementation and reporting. The following paper focuses specifically on the general and experimenter problems in conducting RCTs within psychosocial interventions. It highlights the limitations and inherent problems seen with RCTs of psychosocial interventions so that health care workers are aware of these before considering undertaking psychosocial RCTs with cancer patients.

Bias↗
PubMed1997

Where are we now? Evaluating two decades of group interventions with adult cancer patients.

Substantial evidence suggests that psychosocial interventions are effective in reducing the psychological distress associated with cancer. As the requirement for more cost-effective health care becomes a global concern, considerable focus has been directed towards group interventions with cancer patients. This review examines the literature of intervention groups provided across a wide range of approaches used and illustrates the mental health benefits seen from these studies. Methodological limitations in previous work are examined and ways towards improving research using cancer intervention groups are suggested.

Adult↗
PubMed1997

Psychosocial problems in cancer care: a brief review of common problems.

Worldwide the number of cancer cases continues to increase. Newly diagnosed patients often face more advanced and aggressive therapy as medical advances attempt to provide better survival outcomes. Success in part from improvements of treatment and from early diagnosis means that more cancer patients are living longer with the diagnosis. Given these facts, the following review provides a selective examination of the literature related to treatment problems. In addition, common problems of anxiety, depression, psychosexual and communications issues are examined. The uses of psychological interventions are briefly discussed, and approaches in which mental health nurses in cancer care can contribute to improvements in patient wellbeing are highlighted.

Anxiety↗
PubMed1997

Cancer support groups--are they effective?

Cancer causes significant emotional distress to a considerable majority of patients. Many of these patients typically receive little formal psychological intervention. Support groups, however, have provided one forum from which patients can attempt to gain help and can use to overcome some psychological trauma that accompanies the cancer diagnosis, subsequent treatment and relapse. This article reviews past studies of professionally run cancer support groups as opposed to psychological intervention groups. These studies are considered in light of the proposed benefits and the methodological limitations frequently inherent in such studies.

Adaptation, Psychological↗
PubMed1997

Social support and the cancer patient--a need for clarity.

This paper addresses the importance of social support to the health of cancer patients, drawing upon the relevant literature from medical, psychological and social research. The development of a measure of social support for cancer patients for use in guiding health care and assessing the effects of social support on the patients health statues are needed. Various definitions of social support are considered and the difficulties of adequately defining the concept are discussed. Given the lack of a uniformed definition and emphasis on multiple aspects of social support it is argued that research should address the experiences and needs of patients with cancer. Specifically, with a view to providing a clinical measure of social support. The development of the Bottomley Social Support Scale is outlined and suggestions made for ways forward in researching and understanding social support.

Health Status↗
PubMed1997

Methodology for assessing the prevalence of angina in primary care using practice based information in northern England.

OBJECTIVES: The study aimed to consider the value of nitrate prescriptions issued by general practices as an indicator of coronary heart disease and to compare this with the use of coronary heart disease registers. DESIGN: The study was a cross sectional survey. A self completed questionnaire was used by general practices to indicate an age and gender breakdown of the total practice population, the number of patients taking nitrates, and details of patients recorded on a coronary heart disease register. SUBJECTS: All 48 general practices registered with Wakefield Family Health Services Authority were sent a questionnaire. MAIN RESULTS: The prevalence of angina in the sample population of 164796 was 3.1%. The prevalence of angina as assessed by coronary heart disease registers was significantly higher at 4.3%. CONCLUSIONS: Using questionnaires to assess how many patients are taking nitrates and therefore have angina may provide a quick, "snapshot" view of the prevalence of angina but the methodology is not a robust epidemiological tool. It is likely to provide errors in estimates of true prevalence and risks some under estimation when compared with coronary heart disease registers.

Adolescent↗
PubMed1996

Group cognitive behavioural therapy interventions with cancer patients: a review of the literature.

At present there is considerable evidence that suggests cancer patients, once diagnosed, experience significant and long-term psychosocial problems. Several studies have evaluated group interventions, but only a few have used group cognitive behavioural therapy (GCBT) with cancer patients. The following paper represents a review of the literature of GCBT, illustrating the key findings from these studies.

Cognitive Behavioral Therapy↗
PubMed1995

The development of the Bottomley Cancer Social Support Scale.

At present, no social support scale exists that is cancer-specific. The objective of the study was to develop a cancer-specific scale that not only had validity in reflecting the experiences of cancer patients, but also one that was quick and easy to use in a busy clinical environment. Sixty patients with a primary diagnosis of cancer were selected from oncology wards and out-patient clinics, and they were administered the Bottomley Social Support Scale and the Hospital Anxiety and Depression Scale. The results indicate a valid and reliable social support scale that could be used in conjunction with other measures in a clinical setting. The clinical implications of the measure are that it will allow medical and support staff to assess the levels of social support and implement any appropriate social support interventions.

Adult↗