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C Hürny

Publications and source records attributed to C Hürny.

17 recordsLinked to original sources
PubMed1992

Quality of life measures for patients receiving adjuvant therapy for breast cancer: an international trial. The International Breast Cancer Study Group.

Serial quality of life (QL) assessments are being obtained every 3 months for 2 years from patients with operable breast cancer in two ongoing International Breast Cancer Study Group (IBCSG) randomised clinical trials of adjuvant treatment. The QL-assessments include patient-derived perceived coping (PACIS, personal adjustment to chronic illness scale), well-being (Bf-S, Befindlichkeitsskala von Zerssen), mood, physical well-being and appetite (LASA, linear analogue self assessments). The first assessment within 6 weeks of surgery was performed by 70% of the patients. The analysis of serial assessments for 265 patients with each of the first four assessments completed showed that all measures improved with increasing time from study entry; that the degrees of improvement for the four major language groups were similar; and that measures were sensitive to treatment difference. In conclusion, measurement of QL related aspects in a multicultural clinical trial is feasible and possibly relevant for the evaluation of treatment results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Feasibility of quality of life assessment in a randomized phase III trial of small cell lung cancer--a lesson from the real world--the Swiss Group for Clinical Cancer Research SAKK.

Between 1985 and 1990 the Swiss Group for Clinical Cancer Research (SAKK) for the first time assessed quality of life (QL) variables in 188 patients in a multicenter small-cell lung cancer trial that compared two different regimens of combination chemotherapy. QL-assessment was scheduled at the beginning of each of the six treatment cycles. The self-rating QL questionnaire included an early version of the EORTC QL questionnaire, a mood adjective checklist (Bf-S) and a single linear analogue scale (LASA) measuring general well-being. Compliance with completion of the scheduled questionnaires varied between 37% and 58% over the six cycles, and between 21% and 68% among the 7 participating institutions. Mean compliance was 49%. The institution was found the only significant factor predicting compliance (p < 0.001). Patient age, sex, education and biological prognostic factors at randomization were not predictors of compliance. Although compliance was poor, the data received was of high quality. We suggest practical guidelines for improving compliance with QL data collection in multicenter clinical trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Quality of life in clinical trials of adjuvant therapies. International Breast Cancer Study Group (formerly Ludwig Group).

Clinical trials of adjuvant therapies usually measure the effectiveness of treatments by comparing disease-free survival or overall survival. These take into consideration only indirectly the quality of life experienced by the patients. We present some approaches that were developed to assess the impact of adjuvant therapy on the quality of life of breast cancer patients, as well as new methods created to compare treatments based on time spent without symptoms and toxicity (TWiST). The integration of these two methods (measuring quality and comparing duration of time) will provide a new tool for evaluating benefits from treatments given in the adjuvant setting.

Antineoplastic Agents↗
PubMed1991

On the receiving end. IV: Validation of quality of life indicators.

Four measures of patient functioning and a mood adjective list currently used in trials of the International Breast Cancer Study Group (IBCSG), and an 8-item Linear Analogue Self Assessment (LASA) instrument measuring specific side effects of cancer and cancer treatment (GLQ-8), were cross-validated against three established measures of quality of life, mood and psychological adjustment to cancer, in a heterogeneous sample of cancer patients. Correlations between new and established measures were high, indicating good convergent and concurrent validity. Compliance on the longer mood measures was relatively poor. Despite the difficulty in developing direct and methodologically sound measures of quality of life, the regular inclusion of practical indicators of aspects of quality of life in clinical trials would allow improved assessment of the cost-benefit ratio of treatment to outcome in cancer patients.

Adaptation, Psychological↗
PubMed1990

[Liaison psychiatry in oncology].

The goal of 'liaison' in medicine is the integration of biomedical, psychological and social aspects in the diagnosis and treatment of patients. The notion of 'liaison psychiatry' implicates an addition of the psychiatric aspect from outside. In my view, liaison has to grow within somatic medicine. In oncology an internal integration is in the making. Based on the evolution of psychosocial oncology in Switzerland in the last ten years, the beginning process of integration is explained. The explanation with the biopsychosocial paradigm takes place mainly on two levels, the practical everyday experience and the scientific discussion. As an example of the scientific level, the integration of psychological and social parameters in the evaluation of oncological treatments in the IBCSG (International Breast Cancer Study Group) studies is presented: as an example of the everyday practical level, the authors group-work with physicians and nurses in the oncological outpatient clinic of the University of Bern is described.

Combined Modality Therapy↗
PubMed1989

[Engel's "psychogenic pain and the patient susceptible to pain": a retrospective, controlled clinical study].

Engel's hypothesis of pain-prone patients having a distinct pattern of developmental psychosocial experiences was tested in a controlled design including four groups of 20 patients each: a) psychogenic pain, b) organic pain, c) psychogenic bodily symptoms, d) organic disease. On admission an open-ended interview, including childhood experiences was tape-recorded. Measures were taken to minimize observer-bias. Patients in group a) had, compared to the other groups, significantly increased prevalence of: "Parents, verbally and/or physically abusive of each other", "parents, abusive of the child", "child, deflecting aggression from one parent to the other onto himself", "parents, who suffered from illnesses/-pain", "parent of the same gender as the patient suffering from pain", "pain of patient and parent in the same location", "number of operations in adulthood", "disturbance of interpersonal relationships", and "disturbance of work life". Factor analysis produced two factors explaining 73% of the variance in group a): F1 ("Brutality-Overcompensation") was related to "duration of pain", F2 ("Submission-Inhibition") to "number of operations, accidents" in adulthood.

Guilt↗
PubMed1988

Differential diagnosis of pain in cancer patients.

The differential diagnosis of pain in cancer patients and in patients in whom cancer is suspected can be best attained using a technique of anamnesis that 1. Follows the associations of the patient 2. Accepts biological, psychological, and social factors without prejudice 3. Comprehends the symptom "pain" in its seven dimensions. The list of possible pains includes pain of neoplastic origin, pain due to cancer therapy, somatic pain of nonneoplastic origin, cancer pain increased by psychic factors, and psychogenic pain. The last category includes pain due to conversion and pain as an accompanying sign of the "flight-fight" reaction.

Adult↗
PubMed1987

[Nutritional problems in old age].

Nutritional problems in the elderly are complex and individually diverse, and therefore a differentiated approach ist mandatory. Interactions of social, psychological and biological factors in the nutrition of the elderly are discussed in four clinical cases: problems of procurement and preparation of food in a patient with sensory aphasia and mild organic brain syndrome; problems of food intake and mastication in a patient with stroke; problems surrounding nutritional requirements and absorption of nutrients in a patient with osteoporosis, and problems relating to nutritional components in a patient with constipation. The clinical vignettes illustrate the difficulty of changing eating habits in elderly people. Nutritional policy for the aged involves a dilemma: on one hand, their survival attests to the essential adequacy of their life-long eating practices. On the other hand, the biological, psychological and social changes of old age appear to make some individually tailored adaptation of nutrition appropriate.

Aged↗
PubMedDate not supplied

Engel's "Psychogenic Pain and the Pain-Prone Patient:" a retrospective, controlled clinical study.

Engel's hypothesis of pain-prone patients having a distinct pattern of developmental psychosocial experiences was tested in a controlled design including four groups of 20 patients each: A) psychogenic pain, B) organic pain, C) psychogenic bodily symptoms, and D) organic disease. On admission an open-ended interview, including childhood experiences, was tape-recorded. Measures were taken to minimize observer bias. Patients in group A had, compared to the other groups, significantly increased prevalence of: "Parents, verbally and/or physically abusive of each other," "parents, abusive of the child," "child, deflecting aggression from one parent to the other onto himself," "parents, who suffered from illnesses/pain," "parent of the same gender as the patient suffering from pain," "pain of patient and parent in the same location," "number of operations in adulthood," "disturbance of interpersonal relationships," and "disturbance of work life." Factor analysis produced two factors explaining 73% of the variance in group A: F1 ("Brutality-Overcompensation") was related to "duration of pain," and F2 ("Submission-Inhibition") was related to "number of operations, accidents" in adulthood.

Adult↗