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Biomedical subjects

L Baider

Publications and source records attributed to L Baider.

At least 19 recordsLinked to original sources

The illness trajectory of elderly cancer patients across cultures: SIOG position paper.

BACKGROUND: Due to the aging of the population, cancer has become a health priority worldwide. While the number of elderly cancer patients is rapidly increasing, many barriers still exist to their effective management. Compared with their younger counterparts, the elderly are less likely to receive optimal medical, psychological and spiritual treatment provided in a culturally competent manner. DESIGN: The scanty literature on cultural competence in elderly cancer patients has been reviewed. Additional material has been selected based on the authors' clinical research in medical oncology and psycho-oncology, and on their scholarly work in anthropology and bioethics. RESULTS: The aging process is a synergistic product of biological, behavioral and social issues within a cultural context. Knowledge about how older people understand, perceive and experience their illness trajectory and make choices is essential to the planning and delivering of effective cancer care. CONCLUSION: This position paper of the SIOG Task Force on Cultural Competence in the Elderly creates awareness of the influence of culture in geriatric oncology. Negotiating cross-cultural issues in geriatric oncology helps managing possible conflicts between patients, families and physicians over differing health care values, beliefs, or practices. Possible areas of future scholarly investigation and clinical research are identified.

Aged↗

Changes in psychological distress of women in long-term remission from breast cancer in two different geographical settings: a randomized study.

GOALS OF WORK: Psychological distress and coping styles in women diagnosed with stages I and II breast cancer have attracted substantial clinical and research attention over the last several decades. The contradictory and, at times, controversial findings stimulated the present randomized research whose purpose was to explore the possibility and probability of predicting which variables affect the psychological distress level of women with breast cancer 1 to 5 years after diagnosis (time period 1) and 6 to 8 months after period 1 (time period 2). PATIENTS AND METHODS: The study was conducted in two large oncology centers in Graz, Austria, and Jerusalem, Israel, with a sample population comprising 424 patients. MAIN RESULTS: The only variables that significantly predicted change in the psychological distress levels (Grand Severity Index, GSI; except for the GSI level during period 1) were Fighting Spirit (Mental Adjustment to Cancer, MAC) in the Graz sample and Perceived Family Support (PFS) in the Jerusalem sample. These results are discussed in relation to other findings. CONCLUSIONS: In light of these findings, it is highly important to preliminarily identify women with less adaptive psychological coping mechanisms and to provide them with efficacy tools for behavioral and cognitive changes within their own network of social and health resources.

Adaptation, Psychological↗

Effects of age on coping and psychological distress in women diagnosed with breast cancer: review of literature and analysis of two different geographical settings.

Age-related differences in emotional distress were examined by studying two random samples (N=424) of women diagnosed with early stages of breast cancer in Graz, Austria and Jerusalem, Israel. We found that psychological distress, coping abilities, and different perceptions of illness are attributable to socialization differences of age experience according to young (49 or younger), intermediate (50-64) and old (65 and older) age groups. Patients were interviewed at home to obtain sociodemographic and medical background data. They also completed five standardized instruments (Brief Symptom Inventory, Psychological Adjustment to Illness Scale, Impact of Events Scale, Mental Adjustment to Cancer, and Perceived Family Support). A two-way MANOVA for all the demographic variables yielded significant main group (Graz vs. Jerusalem) effect (P<0.0001), significant main age effect (P<0.0001) and significant interaction (group by age) effect (P<0.001). Examination of the contribution of the age category to the level of the coping variables showed a different pattern in each group. The psychological distress variables revealed that, in the Jerusalem sample, there is a tendency toward decreasing distress levels with age and, in the Graz sample, elevated scores for the intermediate-age group. Age was found to be related to the level of Global Severity Index (GSI) and to the variables correlated to the GSI level. Psychological intervention should be guided to the different age groups.

Adaptation, Psychological↗

Do different cultural settings affect the psychological distress of women with breast cancer? A randomized study.

Breast cancer is the most common malignant disease among women in developed countries. In Austria and Israel, it accounts for 15% and 18%, respectively, of all cancers and 30% of all cancers in women. The purpose of this study, conducted in Graz, Austria, and Jerusalem, Israel, was to determine whether different geographical and cultural settings differentially affect the psychological distress of women who have survived breast cancer and why. The dependence of psychological distress on psychosocial variables such as quality of life, body image, impact of cancer and coping styles was examined at time 1 in a randomized sample of 424 breast cancer women who were disease-free at the time of the study and were surveyed 1-5 years after diagnosis. The most contributing variables to the level of psychological distress in both populations were: the number of stressful life events during last year, financial problems and feeling uncomfortable with the body. Regarding coping styles, mental adjustment to cancer was the principal contributor to psychological distress level [determined by the Grand Severity Index (GSI) scores] in the Graz group, while intrusion was the principal contributor to the GSI level in the Jerusalem group.

Adaptation, Psychological↗

Reality and fugues in physicians facing death: confrontation, coping, and adaptation at the bedside.

This paper addresses the psychological effects and fears of physicians in their private and professional lives. It specifically looks at their experiences, perceptions, behavior, and vulnerability, especially when confronted with death and dying. The concepts of empathy, fears of oncologists, the mechanisms used for adaptation and coping, recommendations and interventions are presented. The success of a physician can be measured by the empathic yet objective relationship he/she establishes with the patient, while simultaneously building clear emotional and professional boundaries.

Adaptation, Psychological↗

Cancer and the spouse: gender-related differences in dealing with health care and illness.

There is a universal assertion that everyone has the right to an adequate standard of physical and mental well-being. Notwithstanding this assertion, different behaviors, responses to stressful events, environmental experiences, and biological processes are seen as contributing factors to individual variations in health and well-being. Until recently, medical treatment for women has been based on a male model, without regard to the fact that women perceive and react differently from men to treatments or that some diseases manifest themselves differently in women and men. In this paper, we review research outcomes and theoretical issues of gender differentiation in illness behavior and psychological behavior of cancer patients and their partners. It is time for the gender-bias paradigm to be re-examined and redefined.

Adaptation, Psychological↗

Transmission of response to trauma? Second-generation Holocaust survivors' reaction to cancer.

OBJECTIVE: Opinions differ about the effects of the Holocaust on the adult offspring of survivors. The authors studied cancer patients who were second-generation Holocaust survivors in an attempt to determine whether they react to their illness with the high distress found to be a characteristic of Holocaust survivors. METHOD: In a study population of women with breast cancer, 106 second-generation Holocaust survivors were compared to 102 women whose parents were not in the Holocaust. Background information was obtained by interviews. In addition, all patients completed three self-reports: the Mental Attitude to Cancer Scale, the Brief Symptom Inventory, and the Impact of Event Scale. RESULTS: The two groups had identical mean scores on the Mental Attitude to Cancer Scale. The offspring of Holocaust survivors had scores on the Brief Symptom Inventory and the Impact of Event Scale that were substantially and significantly higher and in the range of psychopathology. Within the group, married women and women whose mothers were still alive were even more distressed. Other independent variables shed little light on why the second-generation Holocaust survivors suffered from extreme distress. CONCLUSIONS: Second-generation Holocaust survivors are particularly vulnerable to psychological distress and, when faced with a trauma such as breast cancer, react with extreme psychological distress.

Adaptation, Psychological↗

Psychological distress in healthy women with familial breast cancer: like mother, like daughter?

OBJECTIVE: In 1977, the Israel Cancer Association held a one-day conference, on the subject of familial breast cancer, for healthy women with at least one first-degree relative diagnosed with breast cancer. The objective of this study was to assess the psychological distress of a sample of the women who attended. METHOD: Of the 333 healthy women present at the conference, 230 completed three questionnaires: one on sociodemographic data and the medical history of the first-degree relative(s) (mother and/or sister), and two that measure psychological distress: the Brief Symptom Inventory and the Impact of Events Scale. SAMPLE: The subjects were divided into three categorical groups: those whose mother had breast cancer (group A, N = 176), those whose sister had breast cancer (group B, N = 34), and those whose mother and sister both had the disease (group C, N = 20). In addition, subjects were divided into two groups according to the psychological distress level. RESULTS: Analysis of results (using ANOVA and a Chi square test for categorical variables and both univariate and multivariate procedures for psychological distress assessment) showed elevated levels of distress and persistent intrusive thoughts in all groups, and particularly in group C. CONCLUSION: There is a need to promote genetic diagnostic and appropriate counseling, notwithstanding the potential risks that genetic counseling poses for such women.

Adult↗

Changes in cytokine production of breast cancer patients treated with interferons.

A clinical randomized study was performed on advanced breast cancer patients who were treated by interferons (IFN) beta and gamma in combination with hormonotherapy (Megace or Tamoxifen). Cytokine levels (IL-1beta, IL-2, IL-6, TNF-alpha, IFN-gamma) and sIL-2R of individual patients before, during (3 months) and after (6 months) therapy were evaluated and correlated to clinical response according to UICC criteria (responder patients-partial or Complete Response versus non-responder patients-Stable/Progression). Decreases in IL-1beta, IL-6 and sIL-2R were associated with clinical response to therapy versus increases in their levels which corresponded to progression of disease. A significant and dramatic increase in IFN-gamma levels was associated with a favourable response to therapy in the IFNs-treated patients, mainly in the group of Tamoxifen. Baseline levels of sIL-2R and of IFN-gamma were prognostic of clinical response and were found to be the most sensitive cytokine parameters for defining the clinical utility of the combination of IFNs and hormonotherapy in breast cancer patients.

Antineoplastic Agents, Hormonal↗

Cancer in married couples: higher or lower distress?

This study focuses on the question of what occurs when both spouses become seriously ill. Our hypothesis was that psychological distress in married couples involving two ill partners is far higher than when only one partner is ill. The study group comprised 20 married couples, in which both spouses were diagnosed with cancer. Two comparison groups were also studied: 20 married couples with the husband diagnosed with cancer, and 20 couples with the wife diagnosed with cancer. All patients in the three groups completed four self-report scales: the Brief Symptom Inventory (BSI); the Perceived Family Support (PFS); the Impact of Events Scale (IES); and the Mental Adjustment to Cancer (MAC). The healthy spouses completed only the first three scales. Our findings supported the null hypothesis--that is, that the psychological distress in married couples with both partners diagnosed with cancer was not significantly different than when only one partner had cancer. Our findings also showed that neither sociodemographic background, medical condition, nor family support affect patient distress. Gender differences were found with Intrusiveness contributing to the distress of male, but not female, patients. This study confirms and augments earlier work, and shows that partners of cancer patients report a high degree of distress, with this level of distress not being much different from that of the patients.

Adaptation, Psychological↗

The effect of behavioral intervention on the psychological distress of Holocaust survivors with cancer.

METHODS: This study describes a particular psychological intervention offered to a unique self-selected population of cancer patients who, 50 years earlier, had experienced the extreme trauma of the Holocaust. A total of 45 patients in follow-up at the Outpatient Clinic of the Oncology Department at the Hadassah University Hospital were approached. Two self-reports were administered: the Brief Symptom Inventory to assess psychological distress, and the Impact of Events Scale to assess intrusion and avoidance. RESULTS: There was a significant decrease in distress by the specific short-term psychological intervention used in this traumatized population. However, 3 months later the improvement virtually disappeared. CONCLUSION: This study failed to demonstrate a long-lasting effect of behavioral intervention upon Holocaust survivors with cancer.

Adaptation, Psychological↗

Coping with additional stresses: comparative study of healthy and cancer patient new immigrants.

The adjustment and psychological distress of 166 cancer patients, who are new immigrants from the former Soviet Union, was assessed and compared to that of 288 healthy new immigrants from the the former Soviet Union. The healthy new immigrants had many adjustment problems and their psychological distress was fairly high. The cancer patients reported extremely severe psychological distress. In the healthy immigrants, age contributed to distress while family support had significant protective effects especially in the male immigrants. In the patients, these differences were even more extreme with family support being protective in the male group but not in the female group. Intrusiveness (IES) seems to be maladaptive adding to distress. The results clearly indicate that additional stresses, such as immigration, make cancer patients more vulnerable. The results also suggest possible interventions, especially those that will help to decrease intrusiveness.

Acculturation↗

Crossing new bridges: the process of adaptation and psychological distress of Russian immigrants in Israel.

Between the end of 1989 and June 1992, 380,152 Russian Jews left the former Soviet Union for Israel, swelling Israel's Jewish population by nearly 10%. Absorbing great waves of immigrants was not new to Israel. Since its establishment in 1948 and the enactment of its Law of Return, large population groups from dozens of different ethnic and cultural backgrounds had immigrated into the country. In 1992 Israel's Jewish population totaled 4,242,500. Of that number, 360,949 had been born in Asian countries, 458,009 in Africa, 1,252,131 in Europe, and 184,317 in America and Oceana.

Acculturation↗

Psychological intervention with couples after mastectomy.

Cancer is a family affair. Clinical work and research studies have shown that cancer does indeed invade the entire family, and that family members, especially spouses, are often highly distressed individuals. The family in general and the spouse in particular cannot, therefore, be looked on as natural supporters for cancer patients, but rather as a system that is itself in need of help and support.

Breast Neoplasms↗

Progressive muscle relaxation and guided imagery in cancer patients.

The aim of this study was to gather information on the immediate and long-term effects of six sessions of group Progressive Muscle Relaxation with Guided Imagery on the psychological distress of self-referred cancer patients. Patients' psychological distress and coping with cancer were assessed by three self-reports: the Multiple Locus of Control, the Impact of Events Scale (IES), and the Brief Symptom Inventory (BSI). Of the 123 patients who started group therapy, 37 dropped out during its course. The 86 patients who completed the intervention showed marked improvement on both BSI and IES, an improvement maintained over the next 6 months in 58 patients who continued assessment through the followup period.

Adaptation, Psychological↗

Psychological distress in female cancer patients with Holocaust experience.

This study examined whether severe emotional and physical trauma in the past affects the psychological condition of female patients currently afflicted with cancer. Using the Brief Symptom Inventory (BSI), 41 women with cancer, who had sustained extreme trauma during the Nazi Holocaust of the midcentury, were compared with three different groups: a matched group of cancer patients without Holocaust experience, a physically healthy group of female Holocaust survivors, and healthy women without a Holocaust past. Although psychological distress was comparable in the two healthy groups, it was far higher in Holocaust cancer patients than in either their non-Holocaust counterparts or in the group of healthy Holocaust survivors. These results may suggest that the severe trauma of the Holocaust could be responsible for markedly diminished psychological response when such patients are confronted with new stress.

Aged↗