Patient and physician reports of the information provided about illness and treatment: what matters for patients' adaptation to cancer during treatment?

OBJECTIVE: The aim of this study was to examine (a) whether illness representations mediate the relation of the amount of information provided by physicians to patients' adaptation to illness; (b) whether patient-physician agreement on the information provided impacts the aforementioned relationship. The study focused on information that, according to the Common Sense Self-Regulation Model, is essential for adaptation to illness. METHODS: The sample consisted of 93 patients undergoing chemotherapy and their physicians. Indirect (mediation) effects and conditional (moderated) indirect effects were examined using bootstrapping. RESULTS: The more illness and treatment-related information was provided by physicians, the more positive illness representations (specifically, illness consequences, emotional representations, and personal control) were reported by patients. In turn, these illness representations were related to better physical functioning and better adjustment to cancer. The degree of the patient-physician agreement on the information provided did not affect this relationship. CONCLUSIONS: What seems to be more crucial for patients' adaptation to cancer during treatment is the amount of information provided by physicians rather than their agreement with patients on the information provided. Also, there is a need to thoroughly examine the pathways through which information provision impacts adaptation to illness.

Relaxation training significantly reduced blood glucose levels in patients with type 1 diabetes mellitus.

PURPOSE/OBJECTIVE: The present study was designed to test whether adding a relaxation training technique to the medical treatment of patients with type 1 diabetes mellitus could, adjusting for the non-specific factors of therapy, lead to an improvement in the patients' condition. METHOD: Forty-six participants were randomly allocated either to an experimental (intervention) group, receiving weekly sessions of relaxation training, or to a control group (placebo) receiving weekly blood circulation training exercises. Measures included the State and Trait Anxiety Inventory, blood glucose levels, high-density lipoprotein levels, cholesterol levels, body weight, HbA1c levels, the Mood Adjective Checklist (MACL), a diary checklist, and urine glucose levels. Assessment of psychological and physiological parameters was conducted before and upon completion of the intervention (8 weeks). RESULTS: Trait anxiety and the main metabolic measurement of blood glucose levels and HbA1C revealed significant differences over time, predominantly among patients in the intervention group. CONCLUSIONS: Relaxation techniques as an adjunct to medical treatment are a useful tool for patients with type 1 diabetes mellitus.

Accelerometer feedback to promote physical activity in adults with type 2 diabetes: a pilot study.

This study examined whether giving activity feedback to obese, sedentary adults with Type 2 diabetes would improve their adherence to a home-based walking program. 49 subjects were recruited. Ten failed a treadmill cardiovascular test. Another 9 dropped out before the intervention, and 4 dropped out during the intervention. The remaining 26 adults (14 women, 12 men; age M = 48.1 yr., SD = 7.1) received behavioral counseling monthly for 3 mo. regarding exercise. All subjects wore a triaxial accelerometer during these 3 months. Randomly, half of the subjects were blind to the data from the accelerometers, i.e., no feedback, and had counseling based on their self-report diaries. The other half had access to the accelerometer data, got a computerized graph of their physical activity for the period between counseling sessions, and had counseling based on these objective data, i.e., feedback. The feedback group showed an increase in exercise over the 3 mo. The nonfeedback group showed an increase in activity at 1.5 mo. but reverted to their baseline exercise levels at 3 mo. However, analysis of variance showed there was at least an 8% probability that this effect was due to chance, so the hypothesis that feedback would improve exercise adherence could not be supported. Further studies with larger sample sizes and greater control of experimental conditions are needed to determine the utility of objective activity feedback.

A Cognitive-Behavior Therapy Applied to a Social Anxiety Disorder and a Specific Phobia, Case Study.

George, a 23-year-old Greek student, was referred by a psychiatrist for treatment to a University Counseling Centre in Athens. He was diagnosed with social anxiety disorder and specific phobia situational type. He was complaining of panic attacks and severe symptoms of anxiety. These symptoms were triggered when in certain social situations and also when travelling by plane, driving a car and visiting tall buildings or high places. His symptoms lead him to avoid finding himself in such situations, to the point that it had affected his daily life. George was diagnosed with social anxiety disorder and with specific phobia, situational type (in this case acrophobia) and was given 20 individual sessions of cognitivebehavior therapy. Following therapy, and follow-up occurring one month post treatment, George no longer met the criteria for social phobia and symptoms leading to acrophobia were reduced. He demonstrated improvements in many areas including driving a car in and out of Athens and visiting tall buildings.

Changes in health perceptions after exposure to human suffering: using discrete emotions to understand underlying processes.

BACKGROUND: The aim of this study was to examine whether exposure to human suffering is associated with negative changes in perceptions about personal health. We further examined the relation of possible health perception changes, to changes in five discrete emotions (i.e., fear, guilt, hostility/anger, and joviality), as a guide to understand the processes underlying health perception changes, provided that each emotion conveys information regarding triggering conditions. METHODOLOGY/FINDINGS: An experimental group (N = 47) was exposed to images of human affliction, whereas a control group (N = 47) was exposed to relaxing images. Participants in the experimental group reported more health anxiety and health value, as well as lower health-related optimism and internal health locus of control, in comparison to participants exposed to relaxing images. They also reported more fear, guilt, hostility and sadness, as well as less joviality. Changes in each health perception were related to changes in particular emotions. CONCLUSION: These findings imply that health perceptions are shaped in a constant dialogue with the representations about the broader world. Furthermore, it seems that the core of health perception changes lies in the acceptance that personal well-being is subject to several potential threats, as well as that people cannot fully control many of the factors the determine their own well-being.