Walking on thin ice: How cancer survivors manage disclosure at work.

Purpose: Work issues for cancer survivors are often not addressed, although many individuals are diagnosed during central years of employment. To examine the impact of dynamic factors on how survivors navigate disclosure about cancer at work, a semi-structured focus group study was conducted with 27 survivors. Method: Grounded theory was implemented to develop a disclosure model. Results: The disclosure model illustrates pre-disclosure processes, processes during disclosing, and potential outcomes of disclosure, including how perceptions of safety and choice affect the outlet, structure, and the emotional, cognitive, social, and behavioral effects of disclosure. Conclusions: Survivors' disclosure experiences are influenced by a complex interaction of factors at the level of the individual, social support system, work environment, and healthcare system, with perceptions of choice as key points of intervention by psycho-oncology providers.

A group positive psychology intervention for cancer survivors and caregivers: A pilot study of Activating Happiness©.

The purpose of this study was to examine the feasibility and potential concept of a 4-week positive psychology group intervention (Activating Happiness©) for cancer survivors and caregivers that emphasized mindfulness, self-compassion, and gratitude. Nine facilitators led 6 intervention groups for 49 participants (35 cancer survivors, 14 caregivers). Of eligible participants, 63% enrolled and of those, 89% completed all study activities. Participants completed self-report measures at baseline, after the second and final sessions, and 3-month post-intervention, and provided qualitative feedback after the final session. Qualitative data demonstrated that participants found the intervention acceptable. The intervention's potential proof-of-concept was supported by benchmarking outcomes against those reported in randomized controlled trials, with effect sizes for mindfulness, self-compassion, anxiety, and depression for caregivers and survivors, and for pain for survivors comparable to size estimates for efficacy in clinical trials.

Neurobehavior and Mild Traumatic Brain Injury.

Neurobehavioral sequelae after mild traumatic brain injury are multifactorial, often necessitating a multidisciplinary approach. Neurobehavioral sequelae generally resolve within 3 months; when more persistent, a search for contributing factors beyond a brain injury should be done. To accomplish this, a systematic and comprehensive evaluation is recommended to place the complaint in context of the patient's premorbid state. The treatment of neurobehavioral sequelae cannot be accomplished without a clear understanding of the underlying cause, and the treatment must be placed within a patient's social and functional framework. Normalizing the experience through education of patients and their families facilitates recovery.