PubMed Health⌕ Search

Biomedical subjects

M A Andrykowski

Publications and source records attributed to M A Andrykowski.

At least 19 recordsLinked to original sources
PubMed2001

Adherence to recommendations for clinical follow-up after benign breast biopsy.

PURPOSE: Women who undergo a benign breast biopsy are at elevated risk for the subsequent development of breast cancer (BC). Therefore, appropriate clinical follow-up of a benign breast biopsy is important. The present study examines the extent and correlates of nonadherence with follow-up recommendations after a benign breast biopsy. METHODS: Women (n = 114) who had undergone a benign breast biopsy completed an initial telephone interview within 50 days of their biopsy (mean = 21 days). Additional telephone interviews were completed at 4 and 8 months post-biopsy. Measures of BC risk perception, general and BC-specific distress, BC-related attitudes and beliefs, social support, optimism, and informational coping style were completed. Specific recommendations for clinical follow-up and evidence of actual follow-up were obtained from medical records. RESULTS: Of 103 women given a specific recommendation for clinical follow-up, 34% were classified as nonadherent with follow-up recommendations. Logistic regression analyses indicated that nonadherent women were characterized by younger age, recommendations for follow-up by clinical breast examination alone, greater confidence in their ability to perform breast self-examination properly, higher perceived personal risk for BC, and greater BC-specific distress. CONCLUSION: Despite the importance of appropriate clinical follow-up of a benign breast biopsy, about one-third of women did not adhere to recommended follow-up. Risk factors for nonadherence suggest potential avenues for interventions to enhance participation in appropriate clinical follow-up.

Adaptation, Psychological↗
PubMed2001

Posttraumatic growth following breast cancer: a controlled comparison study.

Cancer may be viewed as a psychosocial transition with the potential for positive and negative outcomes. This cross-sectional study (a) compared breast cancer (BC) survivors' (n = 70) self-reports of depression, well-being, and posttraumatic growth with those of age- and education-matched healthy comparison women (n = 70) and (b) identified correlates of posttraumatic growth among BC survivors. Groups did not differ in depression or well-being, but the BC group showed a pattern of greater posttraumatic growth, particularly in relating to others, appreciation of life, and spiritual change. BC participants' posttraumatic growth was unrelated to distress or well-being but was positively associated with perceived life-threat, prior talking about breast cancer, income, and time since diagnosis. Research that has focused solely on detection of distress and its correlates may paint an incomplete and potentially misleading picture of adjustment to cancer.

Aged↗
PubMed2001

Social constraints, cognitive processing, and adjustment to breast cancer.

This cross-sectional study of 70 breast cancer survivors examined relationships among social constraints, behavioral and self-report indicators of cognitive processing, depression, and well-being. On the basis of a social-cognitive processing (SCP) model, it was predicted that social constraints would inhibit cognitive processing of the cancer experience, leading to poorer adjustment. Constraints were positively associated with intrusions, avoidance, and linguistic uncertainty in cancer narratives. Greater uncertainty, intrusions, and avoidance, as well as less talking about cancer were associated with greater depression and less well-being. Intrusions partially mediated the positive constraints-depression relationship. Talking about cancer partially mediated the inverse avoidance-well-being relationship. Findings support the SCP model and the importance of using behavioral indicators of cognitive processing to predict positive and negative psychosocial outcomes of cancer.

Adaptation, Psychological↗
PubMed2000

Symptom structure of PTSD following breast cancer.

Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.

Adult↗
PubMed2000

Continuing participation supports ultrasound screening for ovarian cancer.

The effect of ovarian cancer screening on survival is enabled by women who continue to actively participate in screening. In this report, factors that affect participation are examined. Participants included 13,963 Kentucky women who received 56,392 screens accounting for a 46,113 screening year experience. Background, health history and reasons for participating in transvaginal sonographic screening were collected via a self-reported questionnaire. Screening participants were characterized as > 50 years old, mostly married, well educated, medically insured, health conscious women, living in the vicinity of the screening centre or 51-150 miles away. Approximately 70% of the participants can be considered active in the study based upon a screening visit during the 1997-1998 2-year period. The probabilities of a return screen at 1, 2, 5 and 7.5 years were 77.8%, 72.0%, 58.7% and 50.6%, respectively. A total of 96% of return visits occurred within 2 years, with 33.7% having intervals of < 1 year. Perceived family history was not observed to affect continuation. However, abnormal findings were associated with a shortened participation. These high levels of continuation in ultrasound screening indicate that women take this disease seriously and demonstrate that this disease is of consequence to them.

Adult↗
PubMed1999

Rheumatoid symptoms following breast cancer treatment: a controlled comparison.

The prevalence of rheumatoid symptoms following breast cancer (BC) treatment was examined. Breast cancer patients (n = 111) who were a mean of 27.6 months postcompletion of BC treatment and 99 otherwise healthy women with benign breast problems (BBP) completed a self-report measure that assessed current joint pain, swelling, and stiffness, as well as measures of quality of life. Results supported a hypothesized link between BC and rheumatoid symptoms: (1) the BC group was more likely to report joint stiffness lasting more than 60 min following morning waking; (2) the prevalence of unilateral or bilateral joint point or swelling was greater (P < 0.10) in the BC group for four of 10 joint-symptom combinations examined, with differences between the BC and BBP groups in upper extremity joint swelling particularly pronounced; and (3) 41% of the BC group reported that current rheumatoid symptoms exceeded those experienced prior to diagnosis. Within the BC group, the data did not support postchemotherapy rheumatism as an explanation for rheumatoid symptoms. Rather, data suggested that symptoms were associated with surgical management of BC. Finally, among women in the BC group with the most severe joint pain, only a minority were receiving medication for these symptoms. Given the relationship between rheumatoid symptoms and quality of life, more systematic research examining potential contributing factors such as menopausal status, concurrent lymphedema, and weight gain is warranted.

Adult↗
PubMed1999

Patients' psychosocial concerns following stem cell transplantation.

Information regarding the nature, frequency, correlates and temporal trajectory of concerns of stem cell transplantation (SCT) recipients is critical to the development of interventions to enhance quality of life (QOL) in these individuals. This study examined psychosocial concerns in 110 SCT (87% autologous) recipients drawn from two SCT centers. Participants were a mean of 46 years of age and 17 months post-SCT (range 3-62 months). Information regarding current and past SCT-related concerns, performance status, and demographic characteristics was collected by telephone interview or questionnaire. Recipients reported a wide variety of psychosocial concerns following SCT. Recipients who were younger, female and evidenced a poorer performance status reported a larger number of post-SCT concerns. Examination of the temporal trajectory of concerns suggests that some concerns are salient throughout the course of post-SCT recovery (eg disease recurrence, energy level, 'returning to normal'), some are salient early in the course of recovery (eg quality of medical care, overprotectiveness by others), and others emerge later in the course of recovery (eg feeling tense or anxious, sexual life, sleep, relationship with spouse/partner, ability to be affectionate). Implications for the development of interventions to enhance post-SCT QOL are identified.

Adult↗
PubMed1999

Self-transformation as a factor in the self-esteem and well-being of breast cancer survivors.

Diagnosis with a life-threatening illness can lead to many changes in one's self. These changes, called self-transformation, are not well understood. The present study used triangulation of methods and measures to (i) describe individual differences in self-transformation among breast cancer survivors, (ii) examine factors associated with self-transformation in breast cancer survivors, and (iii) examine the relationships between self-transformation and self-esteem and well-being in breast cancer survivors and age-matched comparison women without cancer. Cancer survivors (n = 60) participated in structured interviews and both survivors and comparison women (n = 60) completed a set of questionnaires. Narrative analysis revealed three categories of transformation among breast cancer survivors: positive transformation, minimal transformation and feeling stuck. These groups differed by age, marital status and income, but not by disease or treatment variables. Breast cancer survivors in the positive transformation group had significantly higher self-esteem and well-being in comparison with (i) survivors grouped as feeling stuck and (ii) age-matched counterparts without cancer. Cancer survivors who reported feeling stuck had significantly lower self-esteem and well-being than the other groups of survivors and lower well-being in comparison with healthy women of the same age. Findings provide support for the concept of self-transformation and a new understanding of disease, demographic and treatment factors associated with the concept. Findings also suggest that self-transformation may be a factor in the self-esteem and well-being of breast cancer survivors.

Adaptation, Psychological↗
PubMed1999

Feasibility and psychometrics of an ambulatory hot flash monitoring device.

OBJECTIVE: To assess the feasibility and psychometric properties of a lightweight, automated, ambulatory sternal skin conductance monitor to measure frequency of hot flashes (HFs) among breast cancer survivors (BCSs). DESIGN: A total of 19 postmenopausal BCSs and 5 premenopausal healthy comparison women participated by wearing the monitor for 24 h during their normal daily activities, including sleep. HFs were assessed using subjective (diaries, event markers) and objective (skin conductance) methods. RESULTS: Problems with subjective reporting of HFs were reported by 35% of BCSs. Technological problems and discomfort related to wearing the monitor were minimal. A total of 243 HFs were recorded using the skin conductance monitor by 17 BCSs and 5 premenopausal women (BCS group M = 13.4; range, 1-30). Subjective reporting of HFs was associated with a 31-33% false-positive rate. Skin conductance monitoring during waking hours was associated with a 30% false-negative rate. CONCLUSIONS: The monitor is a feasible method for objectively assessing HFs in BCSs. Data support continued use of sternal skin conductance as an objective measure of HF frequency. This technology should prove useful as an objective measure of HFs in future intervention research aimed at alleviating the symptom and improving quality of life among BCSs.

Adult↗
PubMed1999

Population attitudes toward oncology clinical trials.

OBJECTIVE: We examined the attitudes of the Kentucky adult population toward experimental oncology treatment and randomized clinical oncology trials. DESIGN: We conducted a health survey of 654 noninstitutionalized adults randomly selected from Kentucky households. We posed to them a series of questions evaluating demographics, general health, and personality characteristics. We asked specific questions to characterize the subjects' experiences with cancer, their desires for autonomy in medical treatment, their health-related behaviors, and their preconceived opinions about specific cancer screening examinations. We then asked the subjects about their willingness to undergo experimental treatment and their willingness to participate in a randomized clinical oncology trial within the framework of a defined, specific oncology scenario. RESULTS: Of our subjects, 73% were willing to consider an experimental form of therapy of indeterminate benefit; however, only 39% were willing to consider a randomized clinical trial of two therapies, given the same oncology scenario. The influences of demographic factors, general health, personality factors, personal experience with cancer, and desire for autonomy in health care were found to be of minimal importance in predicting a willingness to participate. CONCLUSIONS: A strong negative bias toward randomized clinical trials appears to exist within this population. Continued public education regarding the value of clinical trials to the individual, as well as their selfless benefit to humanity, is clearly needed.

Adult↗
PubMed1999

Menopausal symptoms in breast cancer survivors.

PURPOSE/OBJECTIVES: To examine the prevalence and severity of menopausal symptoms among breast cancer survivors and the relationship between menopausal symptoms and quality of life (QOL). DESIGN: Cross-sectional, descriptive. SETTING: Outpatient breast care center servicing a southeastern city and regional rural areas. SAMPLE: 114 postmenopausal breast cancer survivors with a mean age of 59 years (SD = 10; range = 36-83 years) who were a mean of 34.9 months postcompletion of surgery, radiotherapy, or chemotherapy (SD = 22; range = 4-116 months). METHODS: Telephone interviews were used to assess demographic variables, menopausal status (questions adapted from the Massachusetts Women's Health Study), menopausal symptoms (adapted from the Blatt Menopausal Index), and QOL (SF-12 Health Survey). Disease and treatment information was extracted from medical records and the state cancer registry. MAIN RESEARCH VARIABLES: Menopausal status, menopausal symptoms, and QOL. FINDINGS: The most commonly reported menopausal symptoms (joint pain (77%), feeling tired (75%), trouble sleeping (68%), and hot flashes (66%)) were also the most severe. More than 40% of breast cancer survivors who reported these symptoms rated them as "quite a bit" to "extremely" severe. The total number and severity of symptoms reported was significantly related to the number of years postmenopause but not to time postdiagnosis. Higher prevalence and severity of menopausal symptoms were related to lower physical and emotional QOL. CONCLUSIONS: Menopausal symptoms appear to be a significant problem for breast cancer survivors. IMPLICATIONS FOR NURSING PRACTICE: Nurses can inform women that menopausal symptoms may be experienced following breast cancer treatment and that these symptoms may be more severe than those experienced by healthy women without cancer.

Adult↗
PubMed1998

Hot flashes in postmenopausal women treated for breast carcinoma: prevalence, severity, correlates, management, and relation to quality of life.

BACKGROUND: Research on hot flashes (HFs) after the diagnosis and treatment of breast carcinoma (BC) is scarce. To our knowledge, this research represents the second study of HF prevalence and severity in women with BC and the first study of 1) correlates of HF prevalence and severity, 2) use of HF management strategies, and 3) the relation between HFs and quality of life (QOL) among women with BC. METHODS: Eligible women (n = 136) participated in structured telephone interviews. RESULTS: Of the 114 postmenopausal women interviewed, 65% reported HFs, with 59% of women with HFs (n = 74) rating the symptom as severe. Multivariate analysis revealed that 1) HFs were most common in women with a high school education or less and those who were younger at diagnosis and 2) HFs were most severe in women with a higher body mass index, those who were younger at diagnosis, and those receiving tamoxifen. Among women with HFs, 37% were not using any HF management strategies and 63% expressed interest in learning more regarding > or = 1 strategy. HFs marginally were related to decreased mental and physical QOL using the SF-12 Health Survey (P < 0.10). CONCLUSIONS: The results of the current study significantly contribute to knowledge regarding HFs in women with BC and support the need for carefully controlled clinical trials evaluating interventions for relieving HFs in this population.

Adult↗
PubMed1998

Patients' pretreatment expectations of chemotherapy-related nausea are an independent predictor of anticipatory nausea.

Based on extensive research with animals, classical conditioning theorists have come to regard contingency as the primary factor in the development of conditioned responses. However, recent experimental work with humans has suggested the possibility that participant expectations may also directly contribute to the development of conditioned responses. To date, this phenomenon has not been investigated in clinical settings. Anticipatory nausea (AN) in chemotherapy patients, widely viewed as the best established example of classical conditioning in clinical medicine, provides an opportunity to examine the contributions of patient expectations to the development of a conditioned response outside the laboratory. The present study of 59 breast cancer patients supported the hypothesis that pretreatment patient expectations make a significant (p < .03) contribution to the development of AN after statistically controlling for the strongest conditioning predictor, contingency. These data imply that patient expectations should be considered when evaluating conditioned responses to aversive medical treatments.

Adult↗
PubMed1998

Psychometric evaluation of the Pittsburgh Sleep Quality Index.

The Pittsburgh Sleep Quality Index (PSQI) measures sleep quality and disturbance retrospectively over a 1-month period using self-reports. Although the PSQI has been used in a variety of populations, published psychometric data are limited. The goal of this study was to examine psychometric properties of the PSQI among four populations: bone marrow transplant patients (n=155); renal transplant patients (n=56); women with breast cancer (n=102); and women with benign breast problems (n=159). Results supported PSQI internal consistency reliability and construct validity. Cronbach's alphas were 0.80 across groups and correlations between global and component scores were moderate to high. PSQI scores were moderately to highly correlated with measures of sleep quality and sleep problems, and poorly correlated with unrelated constructs. Individuals with sleep problems, poor sleep quality, and sleep restlessness had significantly higher PSQI scores in comparison to individuals without such problems.

Adult↗
PubMed1998

Postmastectomy/postlumpectomy pain in breast cancer survivors.

Few studies have focused on careful assessment of postmastectomy pain (PMP); a chronic neuropathic pain syndrome that can affect women postlumpectomy or postmastectomy for breast cancer (BC). Study aims were to determine the prevalence of PMP in an outpatient sample of breast cancer survivors (BCS), describe subjective and objective characteristics of PMP, and examine the relationship between PMP and quality of life. Breast cancer survivors (n = 134) participated in telephone interviews, and those reporting PMP (n = 36) were invited to a pain center for further evaluation and treatment. Results show PMP is a distinct, chronic, pain syndrome affecting 27% of BCS. Findings support the need for clinical trials evaluating the effectiveness of nonpharmacological or cognitive behavioral therapies in alleviating mild to moderate PMP.

Adult↗
PubMed1998

Off-treatment fatigue in breast cancer survivors: a controlled comparison.

Fatigue is a common and distressing symptom following cancer treatment. Research examining "off-treatment" fatigue has been weakened by limited assessments of fatigue and lack of suitable comparison groups. The extent of off-treatment fatigue following treatment for breast cancer (BC) was examined. Women with BC (n = 88; mean, 28 months posttreatment) and age-matched women (n = 88) with benign breast problems (BBP), completed a set of fatigue questionnaires at an Initial assessment and a 4-month Follow-up assessment. The BC group reported more fatigue, more weakness, and less vitality relative to the BBP group at both assessments. No relationship was found in the BC group between fatigue and extent of treatment or time since treatment completion. While the results document the existence of off-treatment fatigue following BC, elucidation of the psychobiological processes underlying this symptom and development of clinical management strategies remain as challenges for future research.

Adult↗
PubMed1998

Factors associated with PTSD symptoms following treatment for breast cancer: test of the Andersen model.

The utility of Andersen's (1993, 1994) model of psychologic morbidity following cancer treatment for predicting PTSD symptoms in breast cancer survivors (N = 82) was examined. PTSD symptoms, physical comorbidity, social support, depression history, and pre-cancer traumatic stressors were assessed in a structured telephone interview. Multiple regression analysis indicated that Andersen model variables (physical comorbidity, education, disease stage, cancer treatment, depression history, social support) accounted for 39% of variance in PTSD symptom reports (p < .001). Addition to the model of time since treatment completion, pre-cancer traumatic stressors, age at diagnosis, and tamoxifen usage accounted for an additional 16% of variance (p < .001). Higher levels of PTSD symptoms were associated with less social support, greater pre-cancer trauma history, less time since treatment completion, and more advanced disease.

Adult↗