PubMed · 14086837
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R D PALMER. 1963. HAND DIFFERENTIATION AND PSYCHOLOGICAL FUNCTIONING.. https://doi.org/10.1111/j.1467-6494.1963.tb01311.x
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OBJECTIVES: As a result of advances in the treatment of childhood cancer many patients who may previously have had a limited life expectancy, are now surviving into adulthood. More insight is needed into the long-term adjustment of young adult survivors of childhood cancer. The purpose of this study was to (1) assess health-related quality of life (HRQoL), and (2) to explore the role of cognitive coping in relation to HRQoL. METHODS: HRQoL of 353 Dutch young adult survivors of childhood cancer was compared with HRQoL of 507 peers. Linear regression analyses predicted survivors' HRQoL by cognitive coping, independent of the impact of demographics and medical variables. RESULTS: Survivors reported a lower HRQoL than their peers. Health status was the best predictor of the Physical Component Scale of the RAND-36; health status and cognitive coping contributed almost equally well to the Mental Component Scale. The explanatory value of cognitive coping could mainly be attributed to the use of predictive control strategies. CONCLUSIONS: Because current coping seemed to be an important predictor of HRQoL, interventions directed at the coping strategies of survivors should be useful. The strong association between predictive coping and HRQoL stresses the importance of focusing at having positive expectations about the further course of the disease.
Pervasive disturbances in emotional regulation are a frequent problem for patients with complex trauma disorders. Emotional instability is a core diagnostic criterion of borderline personality disorder, in which a high prevalence of physical and sexual childhood abuse has been found. Self-injury, substance abuse, and binge-eating are strategies for coping with unbearable traumatic emotions. Therapeutic strategies for improving emotion regulation include pharmacological and psychological approaches. For the former, serotonin reuptake inhibitors have been shown to improve emotion regulation. The latter, psychotherapeutic techniques are: refocusing attention on positive emotions, imaginative distancing, resource activation, cognitive methods for improving affect differentiation, and fostering confidence in relationships and emotional attachment through the experience of a positive therapeutic relationship.
BACKGROUND: Major depression and adjustment disorders are common psychiatric disorders in patients with cancer, but they are often overlooked in clinical oncology settings. The nurse-assisted screening and psychiatric referral program (NASPRP) has been introduced in clinical practice to facilitate psychiatric treatment for major depression and adjustment disorders. This study assessed the usefulness of the NASPRP and compared it with usual practice. METHODS: The program consists of two stages. In the first stage, consecutive patients newly admitted to the Oncology/Hematology Unit are administered the Distress and Impact Thermometer (DIT) by nurses as a brief screening tool for major depression and adjustment disorders. In the second stage, the nurses recommend psychiatric referral to patients with scores above the cutoff point. Patients' records were reviewed for a 3-month period before the start of the program and during the 3-month period after the start of the program. These records were then compared. RESULTS: Of 157 patients newly admitted during the program period, 86.0% (135/157) completed the DIT and results were positive in 49.6% (67/135), but only 28.2% (19/67) accepted psychiatric referral. Ultimately, 11.5% (18/157) of patients newly admitted were diagnosed with major depression or adjustment disorders and treated by psychiatric service, a significantly higher proportion than during the preceding 3-month period, before the program was begun (2.5%; P = 0.001). CONCLUSION: The NASPRP enabled identification of major depression and adjustment disorders in patients with cancer and introduced them to psychiatric treatment. Nevertheless, there is room for improvement in the program.