Biomedical subjects

M A Andrykowski

Publications and source records attributed to M A Andrykowski.

62 records · Page 4Linked to original sources

PubMedDate not supplied

Psychiatric and psychosocial aspects of bone marrow transplantation.

Bone marrow transplantation (BMT) is being increasingly used to treat children and adults with a variety of life-threatening diseases. Although BMT is a life-saving intervention in many instances, it is a high-technology procedure--both aggressive and life-threatening--associated with an array of physical and psychological stressors. Therefore, psychiatric and psychosocial research and intervention can greatly contribute to the understanding and management of BMT recipients, donors, and their families. Seven major areas of psychiatric and psychosocial concern in BMT are identified and the literature relevant to each area is reviewed.

Adaptation, Psychological↗

PubMedDate not supplied

Risk factors for pain after mastectomy/lumpectomy.

PURPOSE: Careful study of risk factors that predispose an individual to developing postmastectomy pain (PMP) after breast cancer surgery has not been reported. This study examined potential risk factors for PMP including demographic, disease, and treatment variables, as well as surgical factors, such as surgical technique and number of lymph nodes removed. DESCRIPTION OF THE STUDY: Data were collected via telephone interviews and review of medical records. Pain was assessed using the Brief Pain Inventory. The sample included 134 breast cancer survivors who were a mean age of 55 years (SD = 9) and a mean of 35 months postsurgery (SD = 19). RESULTS: Women with PMP (n = 36) were not significantly different from women without PMP (n = 98) on demographic, disease, treatment, or surgical variables. PMP intensity was not significantly associated with age at diagnosis, time postsurgery, or time post-treatment. Contrary to expectation, PMP was found in women postlumpectomy without axillary dissection, women whose intercostobrachial nerve was spared, and women without documented postoperative complications. CLINICAL IMPLICATIONS: Findings suggest that cases of PMP cannot uniformly be identified based on the presence or absence of certain factors. Findings also underscore the need to screen all women for PMP after breast cancer surgery, particularly given the availability of effective pain management therapies.

Adult↗

PubMedDate not supplied

Psychometrics for two short forms of the Center for Epidemiologic Studies-Depression Scale.

The Center for Epidemiologic Studies-Depression Scale (CES-D; L. S. Radloff, 1977) assesses the presence and severity of depressive symptoms occurring over the past week. Although it contains only 20 items, its length may preclude its use in a variety of clinical populations. This study evaluated psychometric properties of 2 shorter forms of the CES-D developed by F. J. Kohout, L. F. Berkman, D. A. Evans, and J. Cornoni-Huntley (1993): the Iowa form and the Boston form. Data were pooled from 832 women representing 6 populations. Internal consistency estimates, correlations with the original version of the CES-D, and omitted-included item correlations supported use of the Iowa form over the Boston form when a shortened version of the scale is desired. Regression statistics are provided for use in estimating scores on the original CES-D when either shortened form is used. Factor analytic results from two populations support a single-factor structure for the original CES-D as well as the short forms.

Adolescent↗

PubMedDate not supplied

Do participants' reports of symptom prevalence or severity vary by interviewer gender?

BACKGROUND: Although interviews are commonly used to gather research data, the integrity of interview data can be threatened by discrepancies between interviewers and respondents on such characteristics as race, gender, or age. OBJECTIVES: To determine if participants' reports of the prevalence and severity of 30 symptoms varied as a function of interviewer gender. Symptoms that were assessed included general physical symptoms (diarrhea, headaches), psychological symptoms (feel blue and depressed, worry about nervous breakdown), and menopausal symptoms (hot flashes, vaginal dryness). METHOD: Structured telephone interviews were completed by 137 women who were a mean of 56.5 years old (SD = 11.1, range 36-83) and a mean of 38.8 months (SD = 23.6) postdiagnosis of breast cancer. Interviewers included two women and two men. RESULTS: Symptom prevalence and severity did not vary as a function of interviewer gender. CONCLUSIONS: Findings suggest that both male and female interviewers can be used successfully to assess participants' reports of physical, psychological, or menopausal symptoms.

Adult↗

PubMedDate not supplied

The role of anxiety in the development of anticipatory nausea in cancer chemotherapy: a review and synthesis.

The role of state anxiety in the development of anticipatory nausea and vomiting (ANV) in cancer chemotherapy has been the focus of considerable empirical investigation and theoretical speculation. However, while some relationship between state anxiety and ANV is presumed to exist, determination of its precise nature has proven elusive. Specific hypotheses linking state anxiety to ANV are described and evaluated in light of the empirical evidence. These hypotheses include (a) ANV is a symptomatic concomitant of state anxiety; (b) state anxiety directly facilitates the classical conditioning of ANV; (c) state anxiety exacerbates the magnitude of post-treatment nausea and vomiting experienced, thus increasing the risk of ANV; (d) ANV causes infusion-related state anxiety; and (e) the observed relationship between ANV and state anxiety is a result of methodological artifact. It is concluded that state anxiety can play a causal role in the development of ANV in some patients. In particular, the hypothesis that state anxiety exacerbates post-treatment nausea and vomiting and thus increases the risk for ANV appears best supported by the data. Finally, the clinical implications of the relationship between ANV and state anxiety for the treatment and prevention of ANV are discussed.

Antineoplastic Agents↗

PubMedDate not supplied

The role of psychological variables in post-chemotherapy nausea: anxiety and expectation.

Post-treatment nausea (PN) is a common side effect following cancer chemotherapy. Wide variability in PN is often evidenced among patients even within a specific drug regimen and dosage combination. Such variability might reflect the influence of psychological factors, such as anxiety and expectations for nausea, on the experience of PN. Sixty-five chemotherapy patients were studied across their initial two to four infusions. Ratings of state anxiety and PN were obtained for each infusion. Expectations for chemotherapy-related nausea were assessed prior to the initial infusion. Hierarchical regression analyses indicated that state anxiety was significantly related to the experience of PN while expectations for nausea were unrelated to PN. Subanalyses indicated that the strength of the anxiety-PN relationship was inversely related to the emetic potential of the chemotherapy regimen a patient received. It was concluded that understanding of the factors that contribute to the experience of PN necessitates consideration of not only pharmacological, but psychological and physiological, factors as well.

Antineoplastic Agents↗

PubMedDate not supplied

Psychosocial factors predictive of survival after allogeneic bone marrow transplantation for leukemia.

Previous research suggesting a link between psychosocial variables and survival after bone marrow transplant (BMT) has been limited by: a) retrospective assessment of psychosocial variables; and b) failure to concurrently examine a comprehensive set of disease, treatment, and demographic variables potentially related to post-BMT survival. The present study prospectively assessed psychosocial variables (depressed mood, functional quality of life, and mental adjustment to cancer) that have been linked to survival after BMT and/or malignant disease. Study participants (N = 42) received allogeneic BMT for either acute or chronic leukemia. Analyses using Cox proportional hazards regression indicated that quality of bone marrow graft match was the only disease, treatment, or demographic variable significantly associated with post-BMT survival (p = .05). Addition of psychosocial variables to a multivariate Cox regression model including quality of graft match suggested that an attitude toward cancer characterized by "anxious preoccupation" (p = .008), as well as poorer functional quality of life (p = .052), were each independently associated with poorer post-BMT survival. Further research is necessary to identify the mechanisms by which psychosocial variables could contribute to post-BMT survival.

Adaptation, Psychological↗

PubMedDate not supplied

Posttraumatic stress disorder symptoms after bone marrow transplantation for breast cancer.

OBJECTIVE: On the basis of revisions of DSM criteria, questions have been raised concerning the occurrence of posttraumatic stress disorder (PTSD) symptoms among adults who have been diagnosed and treated for life-threatening illnesses. The present study examined the prevalence and correlates of PTSD symptoms among women who had undergone autologous bone marrow transplantation (ABMT) for breast cancer. METHODS: Participants were 43 women who had undergone ABMT for breast cancer an average of 19 months previously (range = 2 to 62 months) and had no clinical evidence of disease at their most recent follow-up visit. PTSD symptoms and quality of life were assessed using standardized self-report instruments. RESULTS: Between 12% and 19% of participants were likely to meet DSM-IV criteria for the current diagnosis of PTSD. Women who were less well educated, had more advanced disease at the time of the transplantation and had longer hospital stays for the transplantation reported more symptoms of PTSD. Greater PTSD symptomatology was associated with reports of poorer physical health, mental health, and sleep quality. CONCLUSION: Comparisons with previous research suggest that rates of PTSD are higher among women who undergo ABMT as opposed to less intensive forms of breast cancer treatment. These findings are consistent with the view that development of PTSD symptoms is associated with the degree of life threat. The clinical significance of PTSD in this patient population is underscored by findings indicating that greater PTSD symptoms are associated with poorer health-related quality of life.

Adult↗