Biomedical subjects

Bernadine Cimprich

Publications and source records attributed to Bernadine Cimprich.

9 recordsLinked to original sources

PubMed2005

Pre-treatment factors related to cognitive functioning in women newly diagnosed with breast cancer.

Women treated for breast cancer have shown cognitive deficits with reduced capacity to focus and concentrate or to direct attention. This study examined the relationship between cognitive function prior to any treatment for breast cancer and individual factors including age, education, menopausal status, chronic health problems, and distress. Women newly diagnosed with breast cancer (N=184), ages 27-86 years, were assessed with standardized attention tests, self-reports of effectiveness in cognitive functioning, and measures of distress at about 18 days before surgery. Measured performance on the cognitive tests was not significantly correlated to self-reports of effectiveness in cognitive functioning. Age, education, presence of a chronic health problem, and menopausal status, but not distress, were associated with performance on the cognitive tests. Only age and education, however, were significant (p<0.001) predictors of overall performance on the cognitive tests, when controlling covariates. In contrast, symptom and mood distress significantly (p<0.001) predicted perceptions of effectiveness in cognitive functioning. Thus, different factors were associated with measured performance versus self-reports of cognitive functioning. Individual factors that predispose to lowered effectiveness in cognitive functioning prior to treatment in women newly diagnosed with breast cancer are discussed.

Adult↗

PubMed2005

Reducing symptom limitations: a cognitive behavioral intervention randomized trial.

Until now, little research has been conducted examining the reactive dimension, or the degree to which a symptom limits an individual's life, in a multiplicity of symptoms. This research examines how problem-solving therapy organizes an intervention to decrease symptom limitations. The purpose was threefold: to determine if a cognitive behavioral intervention decreases the impact of symptom limitations among individuals newly diagnosed with cancer, who are receiving chemotherapy; to determine, after adjusting for covariates, how symptom limitations change over time; and to describe which symptoms are most limiting. This randomized control trial was conducted in two comprehensive and four community cancer centers. Two hundred thirty-seven individuals, aged 31-87, newly diagnosed with solid tumor cancers, participated. The experimental group (118 individuals) received a 10-contact, 18-week cognitive behavioral intervention focused on cancer- and chemotherapy-related symptoms. The control group (119 individuals) received conventional care. Interviews occurred at baseline, 10, 20, and 32 weeks. Data analysis used a two-level hierarchical linear model. Participants receiving the cognitive behavioral intervention had lower scores of symptom limitation than did participants in the control group. At the onset of the study, younger patients reported more symptom limitations than their older counterparts; however, this was reversed by the end of the study. The cognitive behavioral intervention was key to decreasing symptom limitations. Findings also suggest that nursing interventions may be particularly helpful to younger individuals in managing cancer-related symptom limitations.

Adult↗

PubMed2005

Taking CHARGE: A self-management program for women following breast cancer treatment.

The purpose of the study was to develop and evaluate Taking CHARGE, a self-management intervention designed to facilitate successful transitions to survivorship after breast cancer treatment. The Taking CHARGE intervention involves a two-pronged approach building on self-regulation principles to (1) equip women with self-management skills to address concerns following breast cancer treatment, and (2) provide information about common survivorship topics. The program involved four intervention contacts, two small group meetings and two individualized telephone sessions, delivered by nurse/health educators. This paper focuses on the process evaluation findings from a preliminary test of the Taking CHARGE intervention conducted with 25 women, aged 34-66 years, completing breast cancer treatment, who were randomly assigned to the intervention group. The process evaluation was conducted to obtain systematic information about the relevance and usefulness of the self-regulation approach, informational aspects, and program delivery. The findings indicated that intervention group participants found the Taking CHARGE program to be timely, relevant, and to have high utility in dealing with concerns that exist following breast cancer treatment. The process evaluation findings provide early evidence of the usefulness of the Taking CHARGE intervention for successful transition to survivorship following breast cancer treatment.

Adaptation, Psychological↗

PubMed2004

Effect of a cognitive behavioral intervention on reducing symptom severity during chemotherapy.

PURPOSE: To describe a randomized trial of a cognitive behavioral intervention on reducing symptom severity among patients diagnosed with solid tumors and undergoing a first course of chemotherapy and to determine whether the intervention had an additive or interactive effect on symptom severity in the presence of supportive care medications. PATIENTS AND METHODS: Patients (N = 237) were accrued from comprehensive and community cancer centers, interviewed, and randomly assigned to either the experimental intervention (n = 118) or conventional care (n = 119). A symptom severity index, based on summed severity scores across 15 symptoms, was the primary outcome. Each patient's site of cancer, stage at diagnosis, chemotherapy protocols, and use of supportive medications were learned from medical records. RESULTS: Groups were equivalent at baseline, and attrition by characteristics by group was not different. The proportion of patients not receiving chemotherapy at 10 and 20 weeks did not differ by group. At the 10- and 20-week observations, there was a significant interaction between the experimental group and baseline symptom severity. Patients in the experimental group who entered the trial with higher symptom severity reported significantly lower severity at 10 and 20 weeks. Controlling for chemotherapy treatment status at follow-up and supportive care medications did not alter the effect of the experimental intervention. CONCLUSION: Compared with conventional care alone, the experimental intervention was effective among patients who entered the trial with higher levels of symptom severity. Age, sex, site or stage of cancer, and supportive medications did not modify the effect of this cognitive behavioral intervention on symptom severity.

Adult↗

PubMed2004

Does a symptom management intervention affect depression among cancer patients: results from a clinical trial.

Cancer patients diagnosed with solid tumors and undergoing a first course of chemotherapy were randomized to either conventional care or a 10 contact 20 week cognitive behavioral intervention designed to reduce emotional distress. Three hypotheses were tested. First, a test for a group effect found that patients in the intervention who entered the trial with higher symptom severity reported significantly lower depression at 10 but not 20 weeks. Patients in the experimental group who entered with higher depression were more depressed at 10 weeks than patients in the control group. The second hypothesis compared the intervention in two sub-indices of symptom severity; one comprised of symptoms with a depressive component, the other of symptoms not associated with depression. The intervention was more effective in lowering depression at 10 weeks through an interaction with the non-depressive symptom sub-index. At 20 weeks, a significant main effect for the intervention on depression was observed. No interaction with either sub-index was observed. The third hypothesis found no main or interaction effect between psychotropic drugs and the intervention. In conclusion, behavioral interventions may influence depression differently over time. Initially, the intervention lowered depression through certain symptoms and only later did it effect depression directly. Symptoms with an affective component are relatively unaffected by the intervention which was independent of the presence of psychotropic medications.

Adult↗

PubMed2003

Promoting attentional health: importance to women's lives.

Promoting attentional health is an important opportunity to support and empower women to actively participate in their own health care and function effectively in multiple roles. Attention, the ability to focus or concentrate, is a necessary cognitive resource used throughout the life span in participating in self-health care. However, women can inadvertently overuse this essential capacity, especially when responding to life's multiple demands, resulting in mental or attentional fatigue. When women experience this mental fatigue, many daily activities, including self-health care, are more difficult. An attentional perspective in women's health allows approaches to improve daily functioning and reduce the risk of attentional fatigue. In this article we present the conceptual dimensions of directed attention and its relevance to women's health; practice and research implications are identified.

Attention↗

PubMed2003

An environmental intervention to restore attention in women with newly diagnosed breast cancer.

Earlier research indicated that attentional fatigue with reduced capacity to direct attention in women treated for breast cancer may be ameliorated by a theoretically based intervention involving regular exposure to the natural environment. This study tested the efficacy of a natural environment intervention aimed at restoring attention in 157 women with newly diagnosed breast cancer. Capacity to direct attention was assessed with a brief battery of objective measures at two time points: approximately 17 days before surgery (time 1) and 19 days after surgery (time 2). A randomly assigned intervention protocol was initiated after the first assessment and before any treatment. The intervention comprised a home-based program involving 120 minutes of exposure to the natural environment per week. The intervention group (n = 83) showed greater recovery of capacity to direct attention from the pretreatment (time 1) to the preadjuvant therapy period (time 2), as compared with the nonintervention group (n = 74). A significant effect of the natural environment intervention was observed even after control was used for the effects of age, education, attention scores at time 1, other health problems, symptom distress, and extent of surgery. The findings suggest therapeutic benefits for capacity to direct attention from early intervention aimed at restoring attention in women with newly diagnosed breast cancer.

Adaptation, Psychological↗

PubMed2002

Pain and fatigue management: results of a nursing randomized clinical trial.

PURPOSE/OBJECTIVES: Through a randomized clinical trial, to compare patients undergoing an initial course of chemotherapy who report pain and fatigue at baseline and who are receiving conventional care alone with those receiving conventional care plus a nursing intervention on outcomes reported at 20 weeks. SETTING: Chemotherapy clinics of two comprehensive and two community cancer centers. METHODS: Interviews were conducted at baseline and 10 and 20 weeks. An 18-week, 10-contact nursing intervention utilizing problem-solving approaches to symptom management and improving physical functioning and emotional health was implemented. SAMPLE: The sample consisted of 53 patients in the experimental arm and 60 in the control arm who reported pain and fatigue at baseline. VARIABLES: Pain and fatigue, numbers of other symptoms, and physical role impact and social-functioning subscales from the Medical Outcomes Study 36 Short Form. FINDINGS: Patients who received the intervention reported a significant reduction in the number of symptoms experienced and improved physical and social functioning. Fewer patients in the experimental arm reported both pain and fatigue at 20 weeks. CONCLUSIONS: Behavioral interventions targeted to patients with pain and fatigue can reduce symptom burden, improve the quality of the daily life of patients, and demonstrate the "value-added" role of nursing care for patients undergoing chemotherapy. IMPLICATIONS FOR NURSING: These data support the "value-added" role of nursing interventions for symptom management and improved quality of life during the course of cancer treatment.

Activities of Daily Living↗

PubMedDate not supplied

Age at diagnosis and quality of life in breast cancer survivors.

PURPOSE: The purpose of the study was to determine the relationship between life-stage variables (ie, age at diagnosis and years of survival) and quality-of-life (QOL) outcomes in long-term survivors of breast cancer. DESCRIPTION OF STUDY: In this cross-sectional study, 105 long-term survivors of breast cancer participated in a mailed survey assessing QOL. Participants were selected from a cancer center tumor registry using a stratified random-sampling procedure that was based on age at diagnosis. The Quality of Life-Cancer Survivors scale was used to assess QOL outcomes in the physical, psychological, social, and spiritual domains. RESULTS: Long-term survivors of breast cancer who had received diagnoses at an older age (> 65 years) showed significantly (P <.05) worse QOL outcomes in the physical domain, while those who had received diagnoses at a younger age (27-44 years) showed worse QOL outcomes in the social domain than other age groups. A nonlinear relationship was observed, with long-term survivors who had received diagnoses in middle age (45-65 years) showing better QOL outcomes in the physical domain and in overall QOL. Age at diagnosis and years of survival were significant predictors of QOL outcomes. CLINICAL IMPLICATIONS: These findings indicate that the life stage at diagnosis can help to predict long-term QOL outcomes in breast cancer survivors. Educational strategies to help oncology professionals develop a better understanding of the impact of age at diagnosis may be important in developing tailored interventions that respond to the specific needs of breast cancer survivors at each life stage.

Adult↗