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Biomedical subjects

L L Friedman

Publications and source records attributed to L L Friedman.

6 recordsLinked to original sources
PubMed1998

Physical and psychosocial outcomes of midlife and older women following surgery and adjuvant therapy for breast cancer.

PURPOSE/OBJECTIVES: To investigate the patterns of functioning and psychosocial adjustment of midlife and older women following surgery for breast cancer. Differences between those who received follow-up adjuvant therapy and those who did not also were compared. DESIGN: 2 x 3 mixed design with one between-groups factor (type of treatment) and one within-subjects factor (time). SETTING: Four midwestern hospitals. SAMPLE: 46 patients with breast cancer who are age 55 or older. METHODS: Baseline data about presurgical functional status and other variables were obtained during the first week after surgery. Follow-up data were obtained at six weeks, three months, and six months postsurgery. Data were collected via telephone interviews and mailed questionnaires. MAIN RESEARCH VARIABLES: Functional status, patient symptomatology, quality of life (QOL), demands of illness, and type of treatment (surgery only versus surgery plus adjuvant therapy). FINDINGS: No differences existed between the two treatment groups at baseline, with the exception of lower functional status reported by the surgery-only group. In the surgery-only group, functional status improved significantly from six weeks to three months postsurgery. The most frequently reported symptoms of both groups included fatigue and pain. CONCLUSIONS: These results suggest that both groups did equally well, regardless of whether they received adjuvant therapy (radiation or chemotherapy). Neither QOL nor demands of illness differed between the two groups, nor did these scores change significantly over time following surgery. IMPLICATIONS FOR NURSING PRACTICE: These findings suggest that women undergoing surgery for breast cancer, whether they receive adjuvant therapy or not, may have functional and psychosocial needs that could be effectively addressed by nursing interventions pre- and postsurgery.

Aged↗
PubMed1996

Development and testing of a quality of life model for long-term female cancer survivors.

This research resulted in the evolution of a model depicting the quality of life of long-term female cancer survivors. The foundation for this model's development was Ferrell's (1993) breast cancer model, which incorporates physical, social, psychological and spiritual domains of life. The Ferrell model was adapted following focus-group discussions with 11 long-term female cancer survivors. The adjusted model included new categories, within each of Ferrell's initial domains, that were specific to the focus group participants. Administration of a new instrument, the Long-Term Quality of Life (LTQL), to 187 long-term female cancer survivors produced a final model that included the interaction of all four domains in six major concepts of quality of life. This new model, which reflects the complexity of life in long-term female cancer survivors, may be useful to health professionals in designing interventions to meet the unique needs of these women.

Activities of Daily Living↗
PubMed1996

Long-term female cancer survivors: quality of life issues and clinical implications.

The purpose of this research was to identify concerns and issues related to quality of life in long-term female cancer survivors and to discuss the implications of these issues for nursing. Data were collected by mailed questionnaire to 188 female long-term cancer survivors whose mean age was 61 years. Respondents were recruited through a Michigan tumor registry. The newly developed Long-Term Quality of Life (LTQL) instrument was used to measure quality of life in four domains: physical, psychological, social, and spiritual. We hypothesized that physical concerns would be minimal, whereas psychological, social, and spiritual areas would encompass salient issues. Our hypotheses were supported, with the lowest levels of quality of life found in the areas of spiritual/philosophical views, diet and exercise habits, and social/emotional support; the highest area of quality of life was physical, i.e., the absence of somatic concerns. Long-term survivors have resolved many of the physical concerns resulting from their illness and treatment. However, nursing interventions can still improve quality of life in the psychological, social, and spiritual areas. A multipurpose support group for survivors is recommended, including "exercise partners" to support regular exercise, group discussions of spirituality and philosophical views of life, and community service activities with women's organizations and/or newly diagnosed women.

Adult↗
PubMed1996

Preliminary testing of the Long-Term Quality of Life (LTQL) instrument for female cancer survivors.

The purpose of this study was to develop a quality of life instrument for long-term female cancer survivors. A factor analysis (n = 188) of 34 items resulted in the Long-Term Quality of Life (LTQL) instrument. Internal consistency was high for the four subscales: somatic concerns (alpha = .86), spiritual/philosophical views of life (alpha = .87) fitness (alpha = .92) and social support (alpha = .88). These four factors are congruent with Ferrell's four theoretical domains of quality of life developed for women with breast cancer. Content validity was supported through interrater agreement of subscale items. Significant correlations between the LTQL and the CaRES, an established measure of quality of life, support the concurrent validity of the LTQL. Construct validity was supported by differential subscale scores according to demographic and health status data. Although the LTQL retained all of Ferrell's four domains of quality of life (physical, psychological, social, and spiritual) within one instrument, individual items reconfigured to suggest an overlapping of domains for the long-term female cancer survivor. This research suggests that the LTQL warrants further testing and may be a useful measure of quality of life in long-term female cancer survivors.

Adult↗
PubMedDate not supplied

Complementary therapy use among older cancer patients.

PURPOSE: The purpose of this study was to assess the use of complementary therapies among older cancer patients, to report patterns of use, and to understand who is more likely to use complementary therapies. DESCRIPTION OF STUDY: A survey was conducted of 699 older cancer patients at 4 weeks and 6 weeks into cancer treatment. All participants were 64 years of age or older, had received a diagnosis of breast, colorectal, prostate, or lung cancer, and were recruited from community cancer treatment centers throughout Michigan. Measures of interest included self-reported physical symptoms, depressive symptomatology, optimism, spirituality, and use of conventional and complementary health services. RESULTS: Approximately 33% of older cancer patients reported using complementary therapies. These individuals were more likely to be women, to be breast cancer patients, and to have a higher level of education. The three most frequently used therapies were exercise, herbal therapy, and spiritual healing. Complementary therapy users were significantly more optimistic than nonusers. Also, there were significant differences between users and nonusers on types of physical symptoms experienced, but no differences on reported depressive symptomatology or spirituality. CLINICAL IMPLICATIONS: Oncology providers need to be aware that one third of their older patients are likely to supplement conventional care with complementary therapies. Therefore, providers should be knowledgeable about the safety and efficacy, in particular, of various exercise programs, herbal and vitamin therapies, and spiritual healing. It would be beneficial to develop a system within cancer centers by which patients could easily report on their use of complementary therapies, allowing providers to work in partnership with their patients.

Aged↗