PubMed · 9735781
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P Hufton. Mixed images.. https://pubmed.ncbi.nlm.nih.gov/9735781/
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BACKGROUND: To the authors' knowledge, there had been no evidence for the efficacy of psychosocial intervention among Japanese cancer patients. The objective of this study was to determine the effect of a psychosocial group intervention in reducing psychologic distress and enhancing coping in this population in a randomized controlled trial. METHODS: The patient selection criteria were age younger than 65 years, lymph node metastasis positive and/or histologic or nuclear Grade 2-3, and surgery undergone within the previous 4-18 months as of the start of the study. We conducted a 6-week, structured, psychosocial group intervention. The intervention consisted of health education, coping skills training, stress management, and psychologic support. Subjects were assessed for psychologic distress and coping by administering the Profile of Mood States (POMS), Mental Adjustment to Cancer (MAC) scale, and Hospital Anxiety and Depression (HADS) scale at the baseline, at 6 weeks, and at 6 months. RESULTS: Fifty (33%) of the 151 patients participated and were randomized, and 46 (30%) completed the study. The experimental group had significantly lower scores than the controls for total mood disturbance and significantly higher scores for vigor on the POMS, and significantly higher scores for fighting spirit on the MAC at the end of the 6-week intervention. These improvements were sustained over 6 months of follow-up. CONCLUSIONS: The results of this study suggest that a short term psychosocial group intervention produces significant long term improvement in the quality of life of Japanese patients with primary breast carcinoma.
BACKGROUND: Complementary and alternative medicine (CAM) is often used by cancer patients. Data on characteristics of users, concomitant psychologic disturbance, and compliance with standard treatment continue to be controversial. Use of and interest in CAM and their correlation with psychologic disturbance, ways of coping with illness, and compliance with standard treatment were examined in this study. METHODS: The authors conducted a survey in a consecutive sample of 205 cancer patients undergoing radiotherapy, using a structured questionnaire to record use of and interest in CAM, the Hospital Anxiety and Depression Scale, the Hornheide Questionnaire to assess patient distress and social support, and the Freiburg Questionnaire of Coping with Illness. RESULTS: Of the 172 participants, 24.4% (response rate, 83.9%) reported use of CAM, and 31.4% reported not having used but being interested in such methods. Logistic regression analysis including clinical, demographic, and psychologic characteristics as independent variables yielded 3 predictors of use of or interest in CAM: younger age (P = 0.004; odds ratio (OR), 0.96), progressive cancer (P = 0.064; OR, 1.47), and active coping behavior (P = 0.016; OR, 1.65). Patients interested in or using CAM did not show more psychologic disturbance, poorer social support, or less trust in medicine or compliance with radiotherapy than subjects without such interest. CONCLUSIONS: Use of CAM by cancer patients is not associated with perceived distress or poor compliance with medical treatment but with active coping behavior. Patients seem to consider CAM as supplementary to standard medical methods and one way of avoiding passivity and of coping with feelings of hopelessness.
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