Biomedical subjects

L L Northouse

Publications and source records attributed to L L Northouse.

At least 19 recordsLinked to original sources

PubMed2001

Family survivorship and quality of life following a cancer diagnosis.

The objectives of this study were: (a) to examine the quality of life of the family as a unit during the long-term survivor phase of illness and (b) to test a family model of factors that may influence family quality of life. The family survivorship model, which includes illness survival stressors (family stressors, fear of recurrence, and patient somatic concerns), resources (family hardiness and family social support), appraisal (family meaning of the illness), and the outcome, family quality of life, was used to guide this exploratory cross-sectional study. A random, stratified sample of 123 families (N = 246 individuals) was interviewed 1-5 years after treatment ended. The model explained 63% of the variance in family quality of life, with the strongest predictors being concurrent family stressors, family social support, family member fear of recurrence, family meaning of the illness, and patient employment status. The study findings suggest the importance of addressing cancer-related stressors, family resources, and family meaning as key factors related to family quality of life.

Adult↗

PubMed2000

Couples' patterns of adjustment to colon cancer.

The objectives for this longitudinal study were to: (a) compare colon cancer patients' and their spouses' appraisal of illness, resources, concurrent stress, and adjustment during the first year following surgery; (b) examine the influence of gender (male vs female) and role (patient vs spouse caregiver) on study variables; (c) assess the degree of correlation between patients' and spouses' adjustments; and (d) identify factors that affect adjustment to the illness. Fifty-six couples were interviewed at one week post diagnosis, and at 60 days and one year post surgery. Based on a cognitive-appraisal model of stress, the Smilkstein Stress Scale was used to measure concurrent stress; the Family APGAR, Social Support Questionnaire, and Dyadic Adjustment Scale were used to measure social resources; the Beck Hopelessness Scale and Mishel Uncertainty in Illness Scales were used to measure appraisal of illness; and the Brief Symptom Inventory and Psychosocial Adjustment to Illness Scale were used to measure psychosocial adjustment. Repeated Measures Analysis of Variance indicated that spouses reported significantly more emotional distress and less social support than patients. Gender differences were found, with women reporting more distress, more role problems, and less marital satisfaction, regardless of whether they were patient or spouse. Both patients and spouses reported decreases in their family functioning and social support, but also decreases in emotional distress over time. Moderately high autocorrelations and modest intercorrelations were found among and between patients' and spouses' adjustment scores over time. The strongest predictors of patients' role adjustment problems were hopelessness and spouses' role problems. The strongest predictors of spouses' role problems were spouses' own baseline role problems and level of marital satisfaction. Interventions need to start early in the course of illness, be family-focused, and identify the couples at risk of poorer adjustment to colon cancer.

Adaptation, Psychological↗

PubMed1999

The quality of life of African American women with breast cancer.

The objectives of this study were to describe the quality of life of African American women with breast cancer and test a model of factors that may affect their quality of life. A stress-coping framework that included person (demographics, current concerns, and optimism), social resources (family functioning), and illness-related factors (symptom distress, medical characteristics), as well as appraisal of illness and quality of life, was used to guide this exploratory, cross-sectional study. Participants included 98 African American women who were approximately 4 years postdiagnosis. The women reported a fairly high quality of life, were generally optimistic, and had effective family functioning. Although symptom distress was generally low, a sizable number of women reported problems with energy loss, sleep disturbances, and pain. The model explained 75% of the variance in quality of life, with appraisal, family functioning, symptom distress, and recurrence status each explaining a significant amount of the variance. Current concerns had an indirect effect on quality of life that was mediated by appraisal. These findings underscore the importance of helping women foster a positive appraisal of their illness, manage current concerns, maintain family functioning, and reduce symptom distress, because each of these factors indirectly or directly affects their quality of life.

Adaptation, Psychological↗

PubMed1999

The concerns of patients and spouses after the diagnosis of colon cancer: a qualitative analysis.

PURPOSE: The purposes of this study were to describe the concerns of patients and their spouses after a diagnosis of colon cancer and to identify ways in which health care professionals could assist both patients and their spouses to cope more effectively with this illness and its treatment. DESIGN: Descriptive, cross-sectional study. SETTING AND SUBJECTS: Thirty patients with colon cancer and their spouses completed interviews in their homes. Most patients (83%) had undergone partial colon resection, and 77% had no evidence of cancer in adjacent lymph nodes. Twelve of the patients (40%) had a colostomy at the time the data were collected. METHODS: Patients and spouses participated in semistructured interviews that elicited information concerning their reactions to a diagnosis of colon cancer, to a colostomy (if present), to changes in lifestyle, to their satisfaction with information they received, and to ways that health care professionals could assist them with the illness and treatments. Content analysis was used to analyze the interview data and to group data into inductively derived categories. Interrater reliability was obtained by having 2 researchers independently code the data. RESULTS: Spouses tended to regard a colon cancer diagnosis more negatively than did patients. Both patients and spouses reported that fear of cancer's recurrence was their greatest concern. Most also reported lifestyle changes (80%) as a result of the illness; but the patients reported more changes in their functional ability, whereas spouses reported more changes in their roles and relationships. Half of the patients and most of the spouses (75%) reported a favorable reaction to the colostomy. Approximately half of the couples expressed satisfaction with the information they received; they reported a need for more information about treatments and management of side effects. When asked how professionals could help them, most couples stated that they wanted more information about the expected course of recovery. CONCLUSION: Spouses should be included in health assessment and teaching because they regard the illness more negatively than do patients. Both patients and spouses desire information that will help them to understand the typical course of recovery, assist them to plan for lifestyle changes, and enable them to manage the side effects of treatment.

Adaptation, Psychological↗

PubMed1997

Coping with a breast biopsy: how healthcare professionals can help women and their husbands.

PURPOSE/OBJECTIVE: To examine the type of information women received from their physicians prior to breast biopsy, to describe women's and their husbands' levels of concern during this time, and to determine the type of help they want from healthcare professionals. DESIGN: Descriptive. SETTING: Homes of couples in the midwestern United States. SAMPLE: 300 women and 265 of their husbands interviewed approximately one week prior to biopsy. METHODS: Interviews using a semistructured questionnaire. MAIN RESEARCH VARIABLES: The type of information women and their husbands receive prior to biopsy, their levels of concern, and the type of help they want from healthcare professionals. FINDINGS: Most women were told prior to biopsy that their breast problem needed further assessment (56%) or was probably not cancer (36%). Only a small group of women were told prior to biopsy that they definitely had cancer (2%) or that their breast problem was suspicious (5%). The majority of women and their husbands reported high levels of concern awaiting the biopsy. Women identified several ways healthcare professionals could help, including providing educational materials, shortening the time between detection and biopsy, offering support, using a personalized approach, and involving family members. Husbands identified many of these interventions but also wanted information on how to help their wives. CONCLUSIONS: Breast biopsy generated a high degree of concern in women and their husbands. Their concerns remained high even though many women were told that they probably did not have cancer. IMPLICATIONS FOR NURSING PRACTICE: To minimize the adverse effects of a biopsy, healthcare professionals need to provide information and support, involve husbands, and shorten the biopsy waiting period.

Adaptation, Psychological↗

PubMed1995

Adjustment of women and their husbands to recurrent breast cancer.

The psychosocial adjustment of women with recurrent breast cancer (N = 81) and their husbands (N = 74) were compared to determine if they report different levels of adjustment, support, symptom distress, hopelessness, and uncertainty. Women with recurrent breast cancer reported more emotional distress than their husbands, but both had a similar number of psychosocial role problems. Women and husbands differed in the amount of support and uncertainty they reported but not in the levels of symptom distress or hopelessness they perceived. Women, in contrast to their husbands, expressed more surprise that their cancer recurred and found the recurrent phase of illness more distressing than the initial diagnosis.

Adaptation, Psychological↗

PubMed1995

Factors affecting couples' adjustment to recurrent breast cancer.

The purpose of this study was to identify factors that affect the adjustment of women and their husbands to recurrent breast cancer and to examine the mutual effect that partners have on one another. An exploratory study was designed to determine the relationship between four predictor variables (support, uncertainty, symptom distress, hopelessness) and women's and husbands' adjustments. The sample consisted of 155 subjects; 81 women, who had a first recurrence of breast cancer, and 74 husbands. Multiple standardized instruments with established reliability and validity were used to measure the study variables. The independent variables were measured with the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale, McCorkle Symptom Distress Scale and the Beck Hopelessness Scale. The dependent variable, psychosocial adjustment, was measured with the Brief Symptom Inventory and the Psychosocial Adjustment to Illness Scale. The results indicated that the independent variables accounted for 43% of the variance in women's distress and 32% of the variance in husbands' distress; they also explained 66% of the variance in women's role adjustment problems and 57% of the variance in husbands' role problems. Symptom distress and hopelessness accounted for the most variance in women's and husbands' levels of adjustment. A significant and positive relationship was found between women's and husbands' adjustment scores, indicating that partners have a mutual influence on one another. The findings suggest that there are multiple factors that influence couples' adjustment to recurrent breast cancer, and that these factors need to be taken into consideration when planning care for women and their partners.

Adaptation, Psychological↗

PubMed1994

Breast cancer in younger women: effects on interpersonal and family relations.

Although breast cancer can have a stressful impact on women of all ages, young women may be particularly vulnerable to the negative effects of the disease. Based on a developmental perspective, this article reviews studies on the emotional impact of breast cancer on young women, their spouses, children, and the marital relationship. Studies indicate that younger women experience more emotional distress than older women, although the inverse relationship between age and emotional distress is not consistent across all studies. Although age does not appear to have a direct relationship to husbands' adjustments, younger husbands reported more problems carrying out domestic roles and a greater number of life stresses than older husbands. Studies on the impact of breast cancer on children are limited in number and scope but indicate that the effects of breast cancer vary according to the developmental level of the child. Directions for further research on young women and their families are suggested.

Adaptation, Psychological↗

PubMed1993

Cancer and the family: strategies to assist spouses.

Research that has been conducted with spouses of cancer patients documents the nature of their stress, the duration of their stress, and the concerns that they confront over the course of the illness. A variety of intervention strategies have been used to assist spouses in dealing with the stressful effects of cancer. Two major categories of intervention strategies are providing information and offering support.

Adaptation, Psychological↗

PubMed1991

Psychologic consequences of breast cancer on partner and family.

Breast cancer can have psychologic consequences not only for patients but also for the entire family system. Research indicates a major impact on the husband, the marital relationship, the children, and family roles and responsibilities. Greater attention needs to be given to the family members to ensure that they get the support they need, and to enable them to maintain their supportive roles with the patient.

Adaptation, Psychological↗

PubMed1990

Models of helping and coping in cancer care.

This paper provides a theoretical analysis of four models of helping and coping as they relate to cancer care. The four conceptual models focus on the issue of whether or not patients should be viewed as responsible for the cause or the treatment of their cancer. The moral model, characterized by the holistic health movement, holds patients responsible for both causing and resolving health problems. The compensatory model, exemplified by cancer education programs, attributes low responsibility to patients for causing health problems but high responsibility for resolving them. The medical model views patients as neither responsible for causing nor for resolving health problems. The enlightenment model, typified by the healing movement, holds people responsible for causing their health problems, but not for resolving them. An attempt is made to examine existing programs in cancer care in light of these models. The present analysis addresses the following questions. Why is each of these models appealing? Why are they sometimes embraced by patients or health care providers? What are the benefits and disadvantages of using each of these models with cancer patients? What happens when the health care provider and patient hold different models regarding the patient's responsibility or participation in the cause of the disease or its treatment? Further research is needed to determine the conditions under which a particular model results in better health outcomes for patients, and to assess how factors such as extent of disease or type of cancer influence the patient's choice of a model.

Adaptation, Psychological↗

PubMed1989

The impact of breast cancer on patients and husbands.

The purpose of this descriptive study was fourfold: (a) to assess the adjustment concerns of patients and husbands after a mastectomy, (b) to describe their reactions to seeing the mastectomy incision, (c) to determine which phase of illness was most stressful for them, and (d) to identify factors that helped them cope with the illness. Tape-recorded interviews were conducted with 50 mastectomy patients and their husbands in the hospital just after surgery and 1 month later. Transcripts were content analyzed by two independent raters. Results indicated that survival concerns were the predominant worries reported by patients and husbands in the hospital and 1 month after surgery. Although most of the husbands reacted well to seeing their wives' mastectomy incision, a small group of husbands reported that it was a difficult experience. Patients and husbands indicated that emotional support, information, attitude, and religion were the factors that helped them cope with the illness during this time.

Adaptation, Psychological↗

PubMed1988