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Biomedical subjects

E P Romsaas

Publications and source records attributed to E P Romsaas.

9 recordsLinked to original sources
PubMed1990

Psychological and mood disturbance associated with the diagnosis and treatment of testis cancer and other malignancies.

Eighty-seven men with testis cancer (TC) and 35 men with other cancers (OC) completed measures of mood (Profile of Mood States) and of personality and psychopathology (Millon Clinical Multiaxial Inventory). Effects of primary disease, phase of diagnosis and treatment, locoregional vs. cytotoxic treatment, age, and marital status on these measures were examined. TC patients appeared more distressed during treatment, particularly during cytotoxic as compared to locoregional treatment, than before or after treatment, and more distressed than OC patients. Being married appeared to buffer the stress of cancer and its treatment. Although treatment, particularly cytotoxic therapy, appeared to result in transient distress, results did not offer strong evidence that cancer and its treatment typically precipitate severe psychopathology.

Adaptation, Psychological↗
PubMed1989

Psychosexual adaptation to breast cancer surgery.

Disturbances associated with a breast cancer diagnosis were defined when psychological assessments from 63 patients with a known breast cancer diagnosis were compared to those from 56 patients with an as yet undiagnosed malignancy. Subsequent assessments from the 56 patients with an undiagnosed breast cancer showed disturbances after they saw a physician compared with the assessments from 72 similar patients ultimately diagnosed as benign. Apprehension apparently arose from clues given before a biopsy was done even though the cancer was not yet diagnosed. Compared with the benign breast disease group, the disturbances in patients suspected or diagnosed with breast cancer were found chiefly in assessments of mood and adjustment, and less in assessments of more durable characteristics of personality, psychopathology, and sexual behavior. Psychological problems associated with breast cancer decreased over time, but residuals persisted for at least 16 months postoperatively. Few differences were found between 41 patients who elected breast-conserving surgery and 78 who were treated with mastectomy. Problems were not eliminated by operations which saved the breast.

Adaptation, Psychological↗
PubMed1987

Factors influencing options in primary breast cancer treatment.

Primary breast cancer treatment is determined by tumor factors and by patient preference. Breast cancer treatments that preserve the cosmetic appearance of the breast are appealing and effective for appropriately selected patients; long-term survival following tumor excision and breast irradiation appears to be comparable to that for mastectomy. Since April 1981, when a protocol was developed and treatment options were offered, factors influencing treatment selection have been analyzed in 206 consecutive primary breast cancer patients. Mastectomy was dictated by tumor-related factors in 96 patients (47%); 110 patients (53%) had the option of mastectomy or conservation--tumor excision plus radiotherapy to the breast. Among these 110 eligible patients, 54 chose conservation (49%) and 56 chose mastectomy (51%). Intraoperative findings for ten patients electing conservation necessitated mastectomy, so conservation was accomplished for 44 (21%) of those treated for breast cancer. Beginning in July 1982, breast cancer patients took a battery of psychosexual assessments before any operation (Profile of Mood States [POMS], Health Locus of Control Scale [HLCS] Locke-Wallace Marital Adjustment Test [MAT], Psychosocial Adjustment to Illness Scale [PAIS], Derogatis Sexual Function Inventory [DSFI], Millon Clinical Multiaxial Inventory [MCMI], and a Breast Cancer Information Test [BCIT]). Comparisons of psychologic and demographic variables were made between patients who chose mastectomy and those who chose conservation. No demographic variable was statistically significantly related to choice, although older women tended to select mastectomy more than younger women. Compared with those who elected conservation, women who elected mastectomy were more tense and anxious (P less than .01), more introverted (P less than .01), felt more depressed and dejected (P less than .05), and reported more sexual problems (P less than .05). Those who elected conservation valued their physical appearance more highly (P less than .01) and were generally more self-interested (P less than .05). Mastectomy was dictated by medical considerations for approximately half of patients with breast cancer. Among candidates for breast conservation, the importance of retaining the breast appeared to be determined to a significant degree by measurable psychological factors.

Body Image↗
PubMed1986

Psychological distress among women with breast problems.

Visiting a physician for evaluation of a breast problem which could be cancer is often assumed to be a highly stressful experience. This study evaluates the degree of emotional distress in women about to undergo examination for signs or symptoms of breast disease. Three hundred twenty-two women who attended the Breast Problem Clinic of the Wisconsin Clinical Cancer Center were studied. Each patient completed standard self-administered psychologic tests to evaluate mood disturbance (Profile of Mood States [POMS]) and responsibility taken for overall health care (Health Locus of Control [HLCS]). Results of these tests were compared to control populations of normal college women and female psychiatric outpatients. The women seen in the Breast Problem Clinic were significantly less distressed on POMS subscales which measure depression, anger, fatigue, and confusion than both psychiatric outpatients and normal college women (P less than 0.001). A second group of 17 women who were seen in the hospital 24 to 48 hours before definitive breast cancer surgery were also studied. Women evaluated as inpatients before breast cancer surgery were more distressed than the women attending the outpatient clinic on most POMS subscales, but were not clearly different from normal college women. No differences between the groups were seen for the HLCS. These data indicate that emotional distress among women attending a breast problem clinic is not extraordinary, but that emotional distress heightens when the diagnosis of breast cancer is known.

Breast Neoplasms↗
PubMed1986

Assessment and resource utilization for cancer patients.

To determine whether rehabilitation counselors and nurses differ in their approaches to using assessment information in care planning, 70 oncology outpatients returning to a comprehensive cancer center for continuing health care were asked to indicate their rehabilitation problems on a checklist. Follow-up consisted of clarifying problems and making relevant resources available to patients. Forty-five patients were followed by a clinic nurse (RN) whose expanded role included assessment and resource utilization functions; 25 were followed by a rehabilitation counselor (RC) whose only role was to perform assessment and resource utilization functions. The RC was found to address a significantly higher proportion of patient problems than the RNs (z = 6.94, p less than .0005). Both the RCs and RNs used many different resources to meet patient needs (43 vs 51). However, RNs used themselves as a resource for 51% of the problems addressed whereas the RC used the RN for 14% of problems addressed (z = -6.01, p less than .0005). Delegation of assessment and resource utilization functions to staff members as a sole responsibility may be an effective way to incorporate rehabilitation into an outpatient oncology setting.

Cancer Care Facilities↗
PubMed1985

Occupational therapy intervention for cancer patients with metastatic disease.

Very little information is available on the role of occupational therapy in the care of cancer patients who are being actively treated for metastatic disease. To gain information on occupational therapy assessment and treatment procedures, we reviewed the records of 54 adult inpatients who received occupational therapy services during a hospital admission. We found that assessment focused on independent living skills, sensorimotor components, and therapeutic adaptations. Treatment also focused on these areas but placed heavy emphasis on physical daily living skills, range of motion, assistive/adaptive equipment, and energy conservation. These findings indicate that occupational therapy has a unique role in the physical care of cancer patients with metastatic disease.

Activities of Daily Living↗