Global meaning and psychological adjustment among survivors of bone marrow transplant.

The purpose of the present study was to examine global meaning (i.e. the belief that life has purpose and coherence) and psychological adjustment in survivors of bone marrow transplantation (BMT). Eighty-five survivors of BMT participated in a telephone interview. Regression analyses demonstrated that after controlling for physical functioning, stressor severity, and gender, global meaning was inversely related to global psychological distress and BMT-related psychological distress (i.e. posttraumatic stress disorder-like symptoms related to the cancer treatment). Global meaning was also positively related to mental health aspects of quality of life (e.g. emotional functioning and social functioning). These findings suggest that global meaning may be an important factor in the psychological adjustment of BMT survivors.

Fears about breast cancer recurrence:.

PURPOSE: Prior research shows that the majority of women diagnosed with breast cancer experience ongoing fears about recurrence. These studies primarily have used Likert scales to determine the extent to which women fear recurrence but have not presented details of women's experiences or addressed the nature of women's fears. This report describes a pilot study designed to capture women's diverse experiences related to the possibility of recurrence. DESCRIPTION OF STUDY: Sixteen women participated in semi-structured interviews about their thoughts and feelings regarding the possibility of breast cancer recurrence. Thematic content coding was used to categorize women's responses. RESULTS: Although some women indicated strong fears about recurrence, the majority expressed more moderate fears. Fears revolved around the possibility of death, further treatment (particularly chemotherapy), emotional difficulties, pain, advancement of the disease, suffering of family members, and loss of the breast. Many women spoke about life circumstances that were more salient than the possibility of recurrence. Women also described events/situations that triggered fears and strategies used for coping with fears. CLINICAL IMPLICATIONS: Results suggest that more systematic investigation of women's fears about breast cancer recurrence is warranted and that clinicians should address the multidimensional nature of women's fears as they relate to other psychological processes and events in women's lives. Moreover, women's life circumstances should be considered when attempting to determine whether a social support intervention might be beneficial or detrimental.

Intrusive thoughts and psychological distress among breast cancer survivors: global meaning as a possible protective factor.

Previous research has consistently demonstrated a positive association between intrusive thoughts about stressful experiences and psychological distress. The strength of this relation, however, has varied considerably across studies. To examine the possibility that an individual's sense of global meaning (i.e., the existential belief that one's life has purpose and order) may moderate the relation between intrusive thoughts and psychological distress, the authors conducted telephone assessments of 61 women who had survived breast cancer. Results confirmed that the frequency of intrusive thoughts was positively related to psychological distress. Global meaning, moreover, moderated the relation between intrusive thoughts and psychological distress consistent with the authors' hypotheses. Among women with lower global meaning, more frequent intrusive thoughts were associated with higher psychological distress. No association was found between intrusive thoughts and psychological distress among those participants with higher global meaning.

Behavioral interventions in the diagnosis, treatment and rehabilitation of children with cancer.

Behavioral interventions used to reduce distress and increase cooperation in children undergoing cancer treatment incorporate: contingency management, cognitive/attentional distraction, hypnosis, systematic desensitization, modeling and behavioral rehearsal. In most cases clinical interventions integrate these procedures into a multimodal intervention package. Although in most behavioral interventions the 'therapist' is a nurse, social worker or child psychologist; parents often take an active role in behavioral intervention. Early return to school can 'normalize' the child's life in the midst of coping with cancer and can promote optimal rehabilitation. More research is needed on the integration of behavioral methods with other therapeutic methods (e.g., pharmacologic). Indeed, research in this area of pediatric oncology must be continuously updated as advances in other areas may affect clinical decisions regarding preferred psychosocial intervention methods.

The transtheoretical model of behavior change: measuring our success one stage at a time.

PIP: The Transtheoretical Model of Behavior Change (TTM), originally developed by James Prochaska and his colleagues, addresses the psychological mechanisms of changing a health behavior. The primary tenet of the TTM is that people move through a series of stages on their way to making a change. The five Stages of Change based on TTM can be applied to various health behaviors, from condom use to smoking cessation to cancer screening. Assessing Stages of Change can be used to demonstrate the beneficial effects of sexuality education programs. These stages, which classify individuals according to their current behavior and their intentions for future behavior, are composed of the following: 1) precontemplation; 2) contemplation; 3) ready for action or preparation; 4) action; and 5) maintenance. Individuals may go through all these stages in a linear fashion, skip stages, or move back and forth between them. Furthermore, this model suggests that education programs should be dependent on the participant's stage of readiness to change and should target the individual's perceptions regarding the pros and cons of the behavior in question.^ieng