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Biomedical subjects

C Cumming

Publications and source records attributed to C Cumming.

13 recordsLinked to original sources

A longitudinal prospective study of health-related quality of life in breast cancer patients following high-dose chemotherapy with autologous blood stem cell transplantation.

This prospective longitudinal study examined both short- and long-term changes in health-related quality of life (HRQL) in 52 breast cancer patients with poor prognosis receiving high-dose chemotherapy (HDC) treatment with autologous blood stem cell transplantation (ASCT). HRQL was measured seven times from baseline to 2 years post enrollment with the Functional Living Index-Cancer (FLIC), the EuroQol (EQ-5D), and a quality of life visual analogue scale. The percentage of questionnaires returned at each assessment time ranged from 80 to 92%. All three measures showed a similar pattern of change, with HRQL decreasing following administration of HDC, and returning to baseline levels 8 weeks post HDC. A repeated-measures analysis of variance showed that the FLIC at 2 years was significantly better than baseline (P=<0.0001). Difficulty sleeping, headaches, and decreased sexual interest were the most common symptoms reported in the longer term. Our results have implications for early psychosocial intervention in the care of breast cancer patients with poor prognosis undergoing treatment with HDC and ASCT because such interventions can further improve the quality of their survival.

Adult↗

Responsiveness of the EuroQol in breast cancer patients undergoing high dose chemotherapy.

OBJECTIVE: To assess the responsiveness of the EuroQol (EQ-5D) by comparing it with the Functional Living Index-Cancer (FLIC) and a self-reported rating of health-related quality of life (HRQL). METHODS: HRQL was measured four times during the course of high dose chemotherapy (HDC) and bone marrow transplantation in 40 patients with stage II and III breast cancer. Measurements were at baseline (T1), pre-HDC (T2), 3 weeks post-HDC (T3), and 3 months post-HDC (T4). RESULTS: Effect size ranged from 1.16 (T1-T3) to 0.66 (T3-T4) for the EQ-5D and 0.85-0.91 respectively for the FLIC. No significant differences in effect sizes between the EQ-5D and the FLIC were found. Repeated measures ANOVA yielded a significant change for all measures, with HRQL decreasing post-HDC and returning to baseline levels by 3 m post-HDC. EQ-5D dimensions changed significantly over time for mobility, self-care, and usual activities. EQ-5D index scores at T3 had a bimodal distribution. Interpretation of psychological changes was facilitated by an analysis of FLIC items. CONCLUSIONS: The EQ-5D is responsive to the clinically large changes associated with HDC in breast cancer patients. The bimodal distribution of the EQ-5D index has implications for the interpretation of EQ-5D change scores.

Alberta↗

Personal styles and ways of coping in individuals who use wheelchairs.

To obtain information about the psychological needs of wheelchair users, 45 subjects participating in a university-based drop-in physical activity centre and outpatient rehabilitation program completed the Personal Styles Inventory and the Ways of Coping Inventory. Three groups of subjects were formed, differentiated by etiology for their disability. Results suggested that subjects with brain injury possessed the most limited coping resources. Subjects with multiple sclerosis were highest of the three groups in the frequency of utilization of emotional coping, they also revealed a fundamentally introverted and stability-based personality style. Subjects with spinal cord injuries utilized a predominantly Problem-solving means of coping: and they revealed a basic personality style characterized as extroverted and stable. The findings suggest that disease process (perhaps through common preexisting psychological characteristics, the nature of the onset and progression of the disease process, and/or tissue damage) may modify the ability to adapt and cope with the need to use a wheelchair. The nature of psychological support to be offered should reflect not only the use of a wheelchair but also the underlying personality and its modification by the nature of the disease process.

Adaptation, Psychological↗

Dietary fiber in hospitalized geriatric patients: too soft a solution for too hard a problem?

Increased fiber in the diet has been shown in the past to improve bowel function in elderly outpatients and in long-term care institutions. A randomized placebo-controlled, double-blind study was conducted in a geriatric ward of an acute-care hospital to see if a palatable form of fiber would decrease the incidence of constipation and use of laxatives. In this patient sample, no beneficial effect of fiber supplementation could be found when used up to three weeks.

Aged↗

Problem resolution and repetition of parasuicide. A prospective study.

Resolution of presenting problems at three-month follow-up was studied in 228 parasuicides. 'Non-resolvers' presented with less severe problems, but prodromes were longer, prior episodes more frequent, and they experienced more powerlessness and internally directed hostility than the resolvers. At follow-up resolvers had improved more on measures of depression, externally and internally directed hostility, locus of control, powerlessness, self-esteem, sensitivity to criticism, and social adjustment. Baseline problem severity, powerlessness (negatively), and 'normlessness' 'predicted' degree of problem resolution, while baseline problem severity, the number of previous parasuicide episodes, and baseline internal hostility (the latter two variables negatively) were associated with problem resolution as a dichotomous variable. Resolvers improved more in social functioning during the follow-up than non-resolvers, but a similar proportion (16%) in each group reported repeat episodes of parasuicide at follow-up.

Adolescent↗

Oral hygiene habits, denture plaque, presence of yeasts and stomatitis in institutionalised elderly in Lothian, Scotland.

The purpose of the present study was to examine the relation between oral hygiene habits, denture plaque, presence of yeasts and stomatitis in institutionalised elderly. A sample of 201 residents, 48-99 yr of age (mean age 82 yr), was selected from four different institutions in Lothian, Scotland. Clinical recordings were carried out under standardised circumstances using well recognised indices. Information about oral hygiene habits was obtained through structured interviews conducted immediately before the clinical examination. A multivariate analysis, principal component, was carried out on the correlated five maxillary denture plaque scores and two components, accounting for 74% and 12% of the variation, were identified. Using these two independent variables, an analysis of variance was carried out testing for significance between the four effects: soaking habits, brushing habits, denture stomatitis and growth of yeasts in the palate together with their interactions. The analysis showed a significant relation between maxillary denture plaque, soaking habits and the presence of denture stomatitis. There was no relation between denture plaque and brushing habits or between denture plaque and growth of yeasts.

Aged↗

The reasons people give for taking overdoses: a further inquiry.

A representative sample of 41 cases of self-poisoning was studied in depth. In each case 'reasons' for taking the overdose, both stated spontaneously and chosen from a presented list, were recorded. The commonest spontaneous reason was the 'wish to die'. Nearly one-third indicated some non-suicidal purpose early in the interview and consistently denied suicidal intent subsequently. Apart from suicidal intent, reasons chosen from the list bore little resemblance to reasons that had been offered earlier in the interview and are therefore of uncertain relevance. Three psychiatric judges attributed reasons for each case based on common-sense criteria. Several reasons were seldom or never chosen by them; four were chosen frequently with good agreement, i.e. communicating hostility, influencing others, relieving a state of mind and suicidal intent. The first two were the most frequently chosen, attributed to 71 per cent and 54 per cent of cases respectively. They were the reasons chosen least frequently by the self-poisoners themselves. Of 23 (56 per cent) subjects indicating suicidal intent, 12 (29 per cent) were judged to be suicidal by psychiatrists. These were not clearly distinguishable on the basis of their original interviews, except that those judged suicidal tended to indicate suicidal intent early in the interviews. The clinical and research implications of these findings are discussed.

Adolescent↗