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  • 1
    Online Resource
    Online Resource
    A pilot study of the impact of a grief camp for children
    Cambridge University Press (CUP) ; 2004
    In:  Palliative and Supportive Care Vol. 2, No. 4 ( 2004-12), p. 403-408
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 2, No. 4 ( 2004-12), p. 403-408
    Abstract: Objective: Research indicates that children benefit from supportive interventions to help them cope with the loss of a loved one. The aim of this pilot study was to evaluate children's perceptions of the effectiveness of a grief camp. Methods: Semistructured interviews were performed with 18 children who attended a weekend-long grief camp. Children also responded to follow-up interviews via telephone. Their parents also completed surveys before camp began and either after camp ended or at a follow-up evaluation. Data were analyzed using descriptive statistics and content coding to uncover key themes in the interviews. Results: Children reported that art activities helped them to express feelings about their grief and release feelings of sadness and worry related to the death. Parents and children felt that the camp was a positive experience and that the children benefited from being in groups with peers who had also lost family members. Significance of results : Evaluating the impact of grief camps, using practical methods such as the ones for this study, is important, as these camps are becoming more popular interventions. Children and parents may benefit from contact at specified follow-up periods after camp to determine if they would benefit from further therapy. Results also provide evidence of the success of this program, which supports the need for funding these types of interventions.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951504040532
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2004
    detail.hit.zdb_id: 2121158-9
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  • 2
    Online Resource
    Online Resource
    Monitoring outcomes during long-term opioid therapy for noncancer pain: Results with the Pain Assessment and Documentation Tool
    Weston Medical Publishing ; 2005
    In:  Journal of Opioid Management Vol. 1, No. 5 ( 2005-11-01), p. 257-266
    Details
    In: Journal of Opioid Management, Weston Medical Publishing, Vol. 1, No. 5 ( 2005-11-01), p. 257-266
    Abstract: The increasingly common practice of long-term opioid therapy for chronic noncancer pain must be guided by ongoing assessment of four types of outcomes: pain relief, function, side effects, and drug-related behaviors. Our objective was to gather initial pilot data on the clinical application of a specialized chart note, the Pain Assessment and Documentation Tool (PADT), which was developed and tested with 27 physicians. This pilot test provided the means to collect cross-sectional outcome data on a large sample of opioid-treated chronic pain patients. Each of the physician volunteers (located in a variety of settings across the United States) completed the PADT for a convenience sample of personally treated chronic pain patients who had received at least three months of opioid therapy. Completion of the PADT required a clinical interview, review of the medical chart, and direct clinical observation. Data from the PADTs were collated and analyzed. The results suggested that the majority of patients with chronic pain achieve relatively positive outcomes in the eyes of their prescribing physicians in all four relevant domains with opioid therapy. Analgesia was modest but meaningful, functionality was generally stabilized or improved, and side effects were tolerable. Potentially aberrant behaviors were common but viewed as an indicator of a problem (i.e., addiction or diversion) in only approximately 10 percent of cases. Using the PADT, physician ratings can be developed in four domains. In this sample, outcomes suggested that opioid therapy provided meaningful analgesia.
    Type of Medium: Online Resource
    ISSN: 1551-7489 , 1551-7489
    URL: Article
    DOI: 10.5055/jom.2005.0055
    Language: Unknown
    Publisher: Weston Medical Publishing
    Publication Date: 2005
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  • 3
    Online Resource
    Online Resource
    Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress
    Elsevier BV ; 2007
    In:  Lung Cancer Vol. 55, No. 2 ( 2007-2), p. 215-224
    Details
    In: Lung Cancer, Elsevier BV, Vol. 55, No. 2 ( 2007-2), p. 215-224
    Type of Medium: Online Resource
    ISSN: 0169-5002
    URL: Article
    DOI: 10.1016/j.lungcan.2006.10.001
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2007
    detail.hit.zdb_id: 2025812-4
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  • 4
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    Online Resource
    An exploration of the utility of hypnosis in pain management among rural pain patients
    Cambridge University Press (CUP) ; 2007
    In:  Palliative and Supportive Care Vol. 5, No. 2 ( 2007-06), p. 147-152
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 5, No. 2 ( 2007-06), p. 147-152
    Abstract: Objective: Hypnosis is an adjunctive, noninvasive treatment with few side effects that can be useful in the management of chronic pain. However, it has fallen into disfavor in recent years and is often perceived by physicians as simple charlatanism. We evaluated the efficacy of this treatment as used clinically in a large, mostly rural, pain management center. Methods: We conducted a chart review of 300 pain patients from the Pain Treatment Center of the Bluegrass who had undergone hypnosis for their pain concerns. A chart audit tool was developed consisting of basic demographics, pre- and posthypnosis pain ratings, a rating of relaxation achieved posthypnosis, and scores on the Beck Depression Inventory, Perceived Disability Scale, and the Pain Anxiety Symptom Scale. Results: The sample consisted of 79 men (26.3%) and 221 women (73.7%) with a mean age of 46.3 years ( SD = 9.9, range = 19–78). Pain levels recorded pre- and posthypnosis revealed significant improvement as a result of the intervention (mean difference = 2.5, t (1,298) = 25.9, p 〈 .001). Patients reported an average of 49.8% improvement in relaxation level posthypnosis ( SD = 24.2%) and had a mean score of 19.0 on the Beck Depression Inventory ( SD = 9.9), indicating moderate levels of depression. Also, patients saw themselves as severely disabled regarding their ability to engage in physical (8.3/10) or job-related (7.7/10) activities. Attempts to identify predictors of hypnosis success were not fruitful with one exception. “Poor” responders to hypnosis reported greater levels of perceived dysfunction in their sexual functioning compared to the “good” responders, F (1,187) = 7.2, p 〈 .01. Significance of results: Hypnosis appears to be a viable adjunct for pain management patients, including those from rural and relatively disadvantaged backgrounds. Prospective trials are needed to examine the utility of this modality in end-of-life and palliative care patients.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951507070216
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2007
    detail.hit.zdb_id: 2121158-9
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  • 5
    Online Resource
    Online Resource
    An open label pilot study of citalopram for depression and boredom in ambulatory cancer patients
    Cambridge University Press (CUP) ; 2003
    In:  Palliative and Supportive Care Vol. 1, No. 1 ( 2003-03), p. 71-77
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 1, No. 1 ( 2003-03), p. 71-77
    Abstract: Objective: Significant levels of depressive symptoms are an impediment to adjustment and affect greater than one-third of people with cancer. The clinical diagnosis of major depression is estimated to occur in 25%. Depression is dramatically underrecognized by oncologists and oncology nurses, and as a result, often undertreated. Clinical experience suggests that antidepressants of virtually all types are well tolerated and potentially efficacious. There is, however, a lack of an evidence base for the use of anti depressants in cancer patients. Methods: We undertook an open-label pilot study using citalopram in 30 cancer patients who reported a high level of depressive symptoms on the Zung Self-Rating Depression Scale (ZSDS). In addition to the ZSDS, eligible patients completed a series of visual analog scales for pain, depression, and sleep disturbance; the Functional Assessment of Cancer Therapy-General Module; and the Purposelessness, Understimulation, and Boredom Scale developed by the research team. Patients began a 2-month course of therapy with citalopram 20 mg, increasing to 40 mg at the end of the fourth week if the patient was in the same range of depressive symptoms as measured by the ZSDS. Results: Twenty-one of 30 patients completed the protocol. The average age of the sample was 57.32 years ( SD = 12.6) and was comprised of 11 women (52.4%) and 10 men (47.6%). Depressive symptoms decreased and quality of life improved during the 8-week treatment period. Of special interest was the rate of improvement in boredom, and using the total boredom score of the PUB, significant improvement compared to baseline was seen in weeks 6 ( F = 5.266, p 〈 .05) and 8 ( F = 9.248, p 〈 .01). Significance of results: Overall, the positive findings suggest the need for a randomized, double-blind, placebo-controlled trial of citalopram in cancer patients. Regarding the interplay of boredom and depression, the relationship between improvements in depressive symptoms and boredom is complex. This is illustrated by the way in which the different elements respond to antidepressant treatment. Depression began to improve almost immediately upon initiation of treatment whereas improvement in boredom does not become evident until week 6.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951503030037
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2003
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  • 6
    Online Resource
    Online Resource
    Initial development of a survey tool to detect issues of chemical coping in chronic pain patients
    Cambridge University Press (CUP) ; 2007
    In:  Palliative and Supportive Care Vol. 5, No. 3 ( 2007-09), p. 219-226
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 5, No. 3 ( 2007-09), p. 219-226
    Abstract: Objective: Completely compliant drug-taking behavior is associated with opioid therapy that is usually highly beneficial to the pain patient, whereas frequent and severe aberrant behavior is generally associated with therapy that is potentially harmful to the patient and borders on addiction. There is a large group of patients in the middle between these two extremes: those who display aberrant behaviors periodically, who may additionally have a mixed response to opioid therapy, the overall results of which are less than satisfying (often in the domain of functionality) to the clinician. We have used the term chemical coping to describe this vast middle ground and seek to begin a line of research starting with the development of a clinically useful tool to identify this subset of patients. Methods: A background review is provided to highlight the need for better understanding of chemical coping. In addition, the first steps in creating a chemical coping tool are discussed, including the results of focus group interviews to determine the clarity, understandability of the items, and to assure that they are not objectionable or offensive. A total of 15 patients and 15 professionals completed this phase of the project. Results: Both the professionals and patients reported that the items were generally clear and understandable. In addition, although the items cover potentially sensitive topics and some were designed with a provocative edge, the respondents had few requested changes. The researchers are moving forward with the next phase of research. Significance of results: The middle ground between compliant medication use and addiction, which we call chemical coping , is poorly understood and woefully underresearched. Despite this gap in our knowledge base, it is an often observed phenomenon. Creating a tool to identify these characteristics can lead to better treatment outcomes and earlier interventions to help improve compliance with medication regimens.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951507000387
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2007
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  • 7
    Online Resource
    Online Resource
    A pilot study to examine the relationship between boredom and spirituality in cancer patients
    Cambridge University Press (CUP) ; 2003
    In:  Palliative and Supportive Care Vol. 1, No. 2 ( 2003-06), p. 143-151
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 1, No. 2 ( 2003-06), p. 143-151
    Abstract: Objective: Spirituality has been neglected when assessing the well-being of cancer patients. Traditionally, researchers have focused on areas such as physical, social, and emotional functioning. However, there is a potential for spirituality to have a large impact on quality of life in patients with cancer. The current study was conducted to investigate the relationship between spirituality and boredom, constraint, social contact, and depression. Methods: A total of 100 oncology patients completed several assessment instruments, including the Purposelessness, Under-stimulation, and Boredom (PUB) Scale, Functional Assessment of Cancer Therapy Scale–Anemia, Brief Zung Self-Rating Depression Scale (BZSDS), Cancer Behavior Inventory, Systems of Belief Inventory, and Eastern Cooperative Oncology Group Performance Status Scale. Results: The average age of the sample was 62.37 years ( SD = 13.43) and was comprised of 60 women (60%) and 40 men (40%). A regression analysis conducted to explore the impact of the variables on quality of life found only the BZSDS ( R 2 Δ = .650, F = 180.392, p 〈 .001) and the PUB Scale ( R 2 Δ = .077, F = 26.885, p 〈 .001) were significant predictors of quality of life. Another set of regression analyses were conducted to explore whether spirituality had a mediating effect on this relationship, but the mediated model was not supported. Significance of results: We conclude that spirituality and boredom are difficult concepts to define, operationalize, and measure, but crucial to our understanding of quality of life in advanced cancer. More research is needed to clarify the nature of the interrelationships between these important concepts.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951503030165
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2003
    detail.hit.zdb_id: 2121158-9
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  • 8
    Online Resource
    Online Resource
    Empathy and the failure to treat pain
    Cambridge University Press (CUP) ; 2007
    In:  Palliative and Supportive Care Vol. 5, No. 2 ( 2007-06), p. 167-172
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 5, No. 2 ( 2007-06), p. 167-172
    Abstract: We set out to discuss the psychological barriers that exist in the treatment of pain. Specifically, we argue that clinicians have several innate mechanisms at play that can hinder their judgment and lead to erroneous assumptions about their patients. Issues are discussed from social psychological and psychodynamic perspectives. A focus is placed on the issue of empathy and how this, too, can act as a barrier to rational judgment when evaluating patients. In the face of growing scrutiny on pain management in the United States, it is important to understand the barriers to providing care that already exist on an intrinsic level. Through the exploration of these barriers, clinicians might be better able to reflect on their own practice. Ultimately, we hope to push forward an agenda of rational therapy in pain management that utilizes safeguards against abuse and addiction while also preserving treatment modalities for patients in need of services.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951507070241
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2007
    detail.hit.zdb_id: 2121158-9
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  • 9
    Online Resource
    Online Resource
    Difficulties in screening for adjustment disorder, Part II: An attempt to develop a novel self-report screening instrument in cancer patients undergoing bone marrow transplantation
    Cambridge University Press (CUP) ; 2004
    In:  Palliative and Supportive Care Vol. 2, No. 1 ( 2004-03), p. 33-41
    Details
    In: Palliative and Supportive Care, Cambridge University Press (CUP), Vol. 2, No. 1 ( 2004-03), p. 33-41
    Abstract: Objective: Screening for adjustment disorder (AD) in cancer patients presents a significant clinical challenge. As seen in Part I of this research, conventional, existing measures are rather poor at detecting this most common of psychiatric diagnoses. Bone marrow transplantation (BMT) has a high level of morbidity that can cause significant stress for patients faced with the procedure. Methods: A sample of 95 BMT patients completed a semistructured interview and a novel self-report instrument, the Coping Flexibility Scale for Cancer (C-Flex), to determine if it could identify patients with adjustment disorder in need of further assessment and intervention. Results: The screen yielded four factors but was not predictive of AD. However, the C-Flex was significantly related to the presence of any disorder ( r = −0.44, p 〈 0.001) in this sample. In addition, Factor I of the screen was found to be correlated to the presence of any diagnosis ( r = −0.44, p 〈 0.001) and to have adequate sensitivity (81.63%) and specificity (76.09%). Significance of results: Either because of problems with the scale or the amorphous nature of the AD category, or both, rapid identification of patients with this common problem has proven to be elusive.
    Type of Medium: Online Resource
    ISSN: 1478-9515 , 1478-9523
    URL: Article
    DOI: 10.1017/S1478951504040052
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2004
    detail.hit.zdb_id: 2121158-9
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  • 10
    Online Resource
    Online Resource
    Abuse and Addiction Issues in Medically Ill Patients With Pain: Attempts at Clarification of Terms and Empirical Study
    Ovid Technologies (Wolters Kluwer Health) ; 2002
    In:  The Clinical Journal of Pain Vol. 18, No. Supplement ( 2002-07), p. S52-S60
    Details
    In: The Clinical Journal of Pain, Ovid Technologies (Wolters Kluwer Health), Vol. 18, No. Supplement ( 2002-07), p. S52-S60
    Type of Medium: Online Resource
    ISSN: 0749-8047
    URL: Article
    DOI: 10.1097/00002508-200207001-00006
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2002
    detail.hit.zdb_id: 1497640-7
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