Faith and mental health in an oncology population.

This study compares faith attitudes versus behaviors for their relationship to mental health in current cancer patients and survivors. This cross-sectional survey of ambulatory patients included Hodge's intrinsic religious motivation scale, Benson & Spilka's concept of God scale, frequency of prayer, and the mental health subscale of the MOS SF-36. One hundred and fifty-eighty patients, mostly women with breast cancer, completed questionnaires (92% return). Mental health was positively related to a concept of a loving God (P < .001) and negatively related to the concept of a stern God (P < .002). Mental health was unrelated to goal of treatment (cure vs. chemotherapy/palliation), frequency of prayer, intrinsic faith motivation, or physical pain. Viewing God as loving was strongly related to better mental health, even in the presence of a poor prognosis or pain.

Trust violated: analgesics for addicts.

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a nonprofit organization dedicated to supporting and advancing compassionate health care delivery that provides hope to the patient, support to caregivers, and encourages the healing process. The Center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Addiction among cancer patients on strong analgesics is a rare but difficult management challenge. The case is presented of a 28-year-old woman with breast cancer and painful bone metastases, suffering with dysfunctional social chaos and addicted to Percocet (oxycodone and acetaminophen). Having broken the trust of her health care team, trust was rebuilt by incorporating the substance abuse clinic and enforcing a contractual agreement. With open and honest support, the team was able to both care for and empower the patient. Issues of trust, liability, opioid tolerance, and barriers to optimal analgesia for cancer pain are discussed.