This study examined characteristics of cancer patients interested in bibliotherapy and their motivation and adherence to a self-help program. The majority of participants were female, over 50 years old, and had education beyond high school. Participants had various cancer types and stages. They reported high autonomous motivation to engage in the program and over half had clinically significant psychological distress. Participants completed on average 80% of the workbook and spent 57 minutes weekly engaging with it. Those with more depressive symptoms spent less time reading. Motivation was unrelated to adherence measures but wanting responsibility for well-being related to seeking social support. The findings support bibliotherapy as an intervention option for a broad range of cancer patients.
Protection of human subjects,Phenomenon ,Methodology,Study design,Theoretical model,Significance of the study,Research problem,
WHAT IS THE IMPACT OF COMFORT CARE VERSES ALTERNATIVE CARE FOR THE CHRONIC DYING PATIENT FAMILY AND THE HEALTH CARE TEAM
LRI05 - Self Help for Distress in Cancer - Is It Time For An RCT [Oct 2005]Alex J Mitchell
This is an academic presentation from 2005 outlining the case for a randomized controlled trial of a self-help programme to help people deal with distress and depression following the diagnosis of cancer
The art of being a failure as a therapist (haley, 1969)Scott Miller
A fantastic article written nearly 50 years ago that is as timely today as it was then. The author outlines several beliefs and practices sure to increase your chances of failing as a therapist.
Many people wonder whether a cancer patient's attitude or personality type can impact their prognosis. In this SlideShare, Dana Nolan, a Mental Health Counselor, takes a closer look at how personality, attitude and cancer relate for our August 2016 support group session.
Summary of current research on routine outcome measurement, feedback, the validity, reliability, and effectiveness of the ORS and SRS (or PCOMS Outcome Management System)
Protection of human subjects,Phenomenon ,Methodology,Study design,Theoretical model,Significance of the study,Research problem,
WHAT IS THE IMPACT OF COMFORT CARE VERSES ALTERNATIVE CARE FOR THE CHRONIC DYING PATIENT FAMILY AND THE HEALTH CARE TEAM
LRI05 - Self Help for Distress in Cancer - Is It Time For An RCT [Oct 2005]Alex J Mitchell
This is an academic presentation from 2005 outlining the case for a randomized controlled trial of a self-help programme to help people deal with distress and depression following the diagnosis of cancer
The art of being a failure as a therapist (haley, 1969)Scott Miller
A fantastic article written nearly 50 years ago that is as timely today as it was then. The author outlines several beliefs and practices sure to increase your chances of failing as a therapist.
Many people wonder whether a cancer patient's attitude or personality type can impact their prognosis. In this SlideShare, Dana Nolan, a Mental Health Counselor, takes a closer look at how personality, attitude and cancer relate for our August 2016 support group session.
Summary of current research on routine outcome measurement, feedback, the validity, reliability, and effectiveness of the ORS and SRS (or PCOMS Outcome Management System)
Psychology: Motivation,Types of Motivation & Theories of MotivationPriyanka Nain
This presentation is basically about Motivation,categories & types of Motivation. It also consists of two theories of Motivation- McClelland's Theory of Needs and Maslow's Theory of Self Actualization.
Motivation PowerPoint PPT Content Modern SampleAndrew Schwartz
142 slides include: understanding needs vs. wants, factors for motivation, employee rewards, offering praise/recognition, types of motivation, job enrichment, the role of money and motivation, incentive programs, motivation ironies, boosting efficiency, 30 ways to motivate, Maslow's hierarchy, how to's and more.
Motivation is like an accelerator in a vehicle. A vehicle keeps moving at the pace decided by its accelerator. The moment accelerator is reduced, vehicle’s speed reduces and it may come to a standstill if there is no further acceleration. Alternatively, if brakes are applied, there will be an abrupt reduction in the speed of the vehicle and it may come to a standstill.
This is true to human beings as well. As long as they are motivated they keep working and producing extraordinary results. The moment there is a drop in their acceleration (motivation), results start diminishing. Of course, applying brakes (dissatisfaction/demotivation) certainly bring them to a halt. The only difference is that unlike a vehicle, human beings have different types of accelerator and brake.
Therefore, the book, Why My Horse Doesn't Drink' will help readers to identify the ways that may accelerate or slow down the speed of their team members. Chapter ‘How to motivate’ talks about the points that accelerate and chapter ‘How not to demotivate’ explains the factors that may work as brakes to performance. Thereby readers will be able to make best use of their vehicle (Team Members).
Motivation PowerPoint Slides include topics such as: understanding needs vs. wants, factors for motivation, employee rewards, offering praise/recognition, types of motivation, job enrichment, the role of money and motivation, incentive programs, motivation ironies, boosting efficiency, 30 ways to motivate, Maslow's hierarchy, how to's and more. Slides can easily be tailored to your specific needs (make handouts, create overheads and use them with an LCD projector) and are available for license. 100+ PowerPoint presentation content slides. Each slide includes slide transitions, clipart and animation. System & Software Requirements: IBM or MAC and PowerPoint 97 or higher. You may use this product over and over again. Royalty Free - Use Them Over and Over Again. Once purchased, download instructions will be sent to you via email. (PC and MAC Compatible).
Brobeck et al. BMC Nursing 2014, 1313httpwww.biomedcentr.docxAASTHA76
Brobeck et al. BMC Nursing 2014, 13:13
http://www.biomedcentral.com/1472-6955/13/13
RESEARCH ARTICLE Open Access
Patients’ experiences of lifestyle discussions
based on motivational interviewing: a qualitative
study
Elisabeth Brobeck1,2*, Sigrid Odencrants2, Håkan Bergh3 and Cathrine Hildingh4
Abstract
Background: According to World Health Organization about 75% of cardiovascular diseases and type 2 diabetes
and 40% of all cases of cancer could be prevented if the risk factors tobacco use, unhealthy diets, physical inactivity
and harmful use of alcohol could be eliminated. Patients often need help in monitoring themselves to make the
proper lifestyle changes and it is important that adequate support is provided to enable the patients to take control
over their health. Motivational interviewing is a framework that can help to facilitate this movement. The aim of this
study was to describe how patients in primary health care settings experience lifestyle discussions based on
motivational interviewing.
Methods: This study has a descriptive design and qualitative content analysis was used as the method. Sixteen
patients who had each visited a registered nurse for lifestyle discussions were interviewed.
Results: The results show that the lifestyle discussions could enable self-determination in the process of lifestyle
change but that certain conditions were required. Mutual interaction between the patient and the nurse that
contributes to a sense of well-being in the patients was a necessary condition for the lifestyle discussion to be
helpful. When the discussion resulted in a new way of thinking about lifestyle and when patient initiative was
encouraged, the discussion could contribute to change. The patient’s free will to make a lifestyle change and the
nurse’s sensitivity in the discussions created fertile soil for change.
Conclusions: This study focuses on MI-based discussions, and the result shows that a subset of patients, who
self-reported that they are motivated and aware of their role in making lifestyle changes, appreciate these strategies.
However, it is not known whether discussions would be experienced in the same way if RNs used another method
or if patients who were less motivated, engaged, or aware of their role in making lifestyle changes were
interviewed.
Keywords: Content analysis, Lifestyle discussion, Motivational interviewing, Nurse, Patient experiences,
Primary health care
Background
Non-communicable diseases (NCDs) such as cardiovascu-
lar diseases, type 2 diabetes, cancers and chronic respira-
tory diseases are by far the leading cause of death globally,
representing 63% of all annual deaths [1]. NCDs are largely
caused of the four risk factors; tobacco use, unhealthy
diets, physical inactivity and harmful use of alcohol [1,2].
* Correspondence: [email protected]
1Department of Research, Development and Education, Halmstad, Sweden
2School of Health and Medical Sciences Örebro University, Örebro, Sweden
Full list of a ...
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
Self-Regulatory Model of Illness Perception .pptxanmolayaz
Leventhal's Self-Regulatory Model of Illness Perception includes:
Overview of Leventhal's Self-Regulatory Model of Illness Perception,
cognitive representation, emotional representation, and model application on breast cancer and lung cancer, coping strategies, techniques, and therapies for the self-regulation model, critique, and limitations
Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.
Study of Depression and Role of Support Groups in Its Management among HIV/AI...paperpublications3
Abstract: The acquired immuno-deficiency syndrome (AIDS) is one of the most dreaded entities that modern medicine has ever had to tackle. Depression is the most frequently observed psychiatric disorder among HIV/AIDS patients. It interferes with all aspects of living and may have a severe negative impact on quality of life. An HIV positive diagnosis is a life changing event and may induce shock, a sense of helplessness, denial, and occasional self blame. Belonging to a support group may be of assistance in preventing depression. PLWHA should be advised to belong to a support group. To improve the role of support groups their sizes should be limited.
Methodology: Aim of the Study: To determine the prevalence of depression among HIV positives and to find out the role Support group in reduction of depression.
Study Setting & Design: A tertiary care hospital, and Positive networks, Cross sectional study.
Sample Size: Study constituted of 100 HIV positive patients, depression was assessed using BDI, The data was collected using a pretested semi structured preformed, after obtaining written informed consent.
Sampling Method: Random Sample
Statistical analysis: Data was be analyzed using SPSS version 11.5, statistical test ANOVA and CHI-SQUARE will be used and P less than 0.05 taken as significant.
Exclusion criteria: people below the age of 18 years and above 65 years patients, who are not given consent.
Study Duration: 6 Months
Data Collection: The data was collected using a BDI –Beck Depression Inventory Scale (annexure 1) The HIV positive subjects were invited to participate in the interview and those who presented for treatment, People were invited to participate in the interview and after obtaining a written informed consent the subjects were recruited in the study. The study details were explained to them that this procedure would not affect the scheduled times of their consultation. The interviews were conducted in medical consultation rooms by the investigator. Each interview lasted an average of 1 hour.
Results: The result showed was that statistically significant (p=0.002) depression among urban area.69.5% were depressed among primary education, 59.4% were depressed among 8-12, 100% were depressed those who are education above 12 standard. There is no statistically significant in education and depression.
62% were depressed daily waged, 61.1% were depressed among salaried, 83.3% were depressed among business, 84.6% were depressed among unemployed
There is no statistically significant depression based on their education.
Unmarried 100% were depressed, 67.3% married were depressed, 100% depressed among divorced, 100%were depressed among spouse, 64.1% were depressed among widowed. There is no statistically significant between depression and marital status.
Psychometric assessment of the Life Satisfaction Questionnaire.docxamrit47
Psychometric assessment of the Life Satisfaction Questionnaire (LSQ) and a
comparison of a randomised sample of Swedish women and those su�ering from
breast cancer
Marianne Carlsson
1
, Elisabeth Hamrin
2
& Ragny Lindqvist
1
1Department of Public Health and Caring Sciences, Caring Sciences Unit, Uppsala University, Sweden; 2Department of
Medicine and Care, Division of Nursing Science, University of LinkoÈping, Sweden
Accepted in revised form 29 August 1998
Abstract. In a previous study, the Life Satisfaction
Questionnaire (LSQ) was developed especially for
women with breast cancer. The aim of the present
study was to assess the psychometric properties of the
LSQ in a randomized sample of Swedish women and
to compare the perceived quality of life with that of
women su�ering from breast cancer. Another aim was
to relate the result to educational background. A total
of 257 women aged 20±80, randomly selected from the
Swedish population register, answered the LSQ. The
result was compared with that from 362 women aged
27±78 su�ering from breast cancer. The construct
validity was calculated by a principal component
analysis, and the reliability by Cronbach a-coe�-
cients. It was concluded that the LSQ has acceptable
validity and reliability. The result also showed that the
women with breast cancer rated their perceived qual-
ity of life higher than women in general with respect to
the quality of personal relations and the quality of
daily activities, but lower for physical symptoms. In
the comparison with respect to educational back-
ground, women with university education rated their
quality of life higher than women with other types of
education. The testing of the LSQ will continue.
Key words: Breast cancer, Psychometric assessment, Quality of life
Introduction
The term `quality of life' refers to a person's perceived
quality of her/his physical, psychological, social and
existential functioning [1]. Several instruments have
been developed to measure quality of life in di�erent
groups of people. Some measure quality of life in
general, e.g. the NHP (Nottingham Health Pro®le)
[2], the SIP (Sickness Impact Pro®le) [3], the Swed-
Qual [4], the MOS SF-36 (Medical Outcome Studies
Short Form) [5, 6], and the QLI (Quality of Life In-
dex) by Ferrans and Powers [7]. Others are more
speci®c, for instance, for cancer patients, the QLI
(Quality of Life Index) by Spitzer et al. [8], the FLIC
(Functional Living Index Cancer) [9], the CIPS
(Cancer Inventory of Problem Scale) [10], the
CARES (Cancer Rehabilitation Evaluation System)
[11], the FACT (Functional Assessment of Cancer
Therapy) [12], and the EORTC QLQ-C30 (European
Organisation for Research and Treatment in Cancer,
Quality of Life Questionnaire) [13].
A literature review by Carlsson and Hamrin [14]
showed that the diagnosis of breast cancer evokes
grief, anger and intense fear in women. But the ma-
jority do not experience long-term emotional distress.
Risk factors for psychological dist ...
Rethinking, rebuilding psychosocial care for cancer patientsJames Coyne
Presented as the 8th Trevor Anderson Psycho-Oncology Lecture, September 8, 2014, Melbourne, Australia.
Discusses how psychosocial care for cancer patients needs to be reorganized so that a broader range of cancer patients are served. Routine screening for distress is unlikely to be an efficient means of countering tendencies of cancer care more generally becoming more organized around time efficiency and billable procedures. Psychosocial care for many cancer patients involves discussions, negotiations, and care coordination they cannot be well fit into the idea of a counseling session. The unsung heroes of providing such care are underappreciated social workers and oncology nurses.
The Meaningful Assessment of Therapy OutcomesIncorporating .docxcherry686017
The Meaningful Assessment of Therapy Outcomes:
Incorporating a Qualitative Study Into a Randomized Controlled Trial
Evaluating the Treatment of Adolescent Depression
Nick Midgley
University College London and Anna Freud Centre, London,
United Kingdom
Flavia Ansaldo
Southwark Targeted Services—CAMHS, London,
United Kingdom
Mary Target
University College London
For many years, there have been heated debates about the best way to evaluate the efficacy and
effectiveness of psychological therapies. On the one hand, there are those who argue that the randomized
controlled trial (RCT) is the only reliable and scientifically credible way to assess psychological
interventions. On the other hand, there are those who have argued that psychological therapies cannot be
meaningfully assessed using a methodology developed to evaluate the impact of drug treatments, and that
the findings of RCTs lack “external validity” and are difficult to translate into routine clinical practice.
In this article, we advocate the use of mixed-method research designs for RCTs, combining the rigor of
quantitative data about patterns of change with the phenomenological contextualized insights that can be
derived from qualitative data. We argue that such an approach is especially important if we wish to
understand more fully the impact of therapeutic interventions within complex clinical settings. To
illustrate the value of a mixed-method approach, we describe a study currently underway in the United
Kingdom, in which a qualitative study (IMPACT-My Experience [IMPACT-ME]) has been “nested”
within an RCT (the Improving Mood With Psychoanalytic and Cognitive Behavioral Therapy [IMPACT]
study) designed to evaluate the effectiveness of psychological therapies in the treatment of adolescent
depression. We argue that such a mixed-methods approach can help us to evaluate the effectiveness of
psychological therapies and support the real-world implementation of our findings within increasingly
complex and multidisciplinary clinical contexts.
Keywords: adolescent depression, randomized controlled trials (RCTs), qualitative research, mixed-
methods design, outcome research
For many years, there have been heated debates about the best
way to evaluate the efficacy and effectiveness of psychological
therapies. On the one hand, there are those who argue that the
randomized controlled trial (RCT) (and meta-analyses of such
trials) is the only reliable and scientifically credible way to assess
psychological interventions. The RCT has long been considered
the “gold standard” approach, placed at the top of the “hierarchy of
evidence” and given almost exclusive credence by bodies such as
the Cochrane Collaboration and guideline developers such as the
National Institute for Health and Clinical Excellence (NICE). On
the other hand, there are those who have argued that psychological
therapies cannot be meaningfully assessed using a methodology
developed to evaluate the impact of drug treatme ...
2006 presentation at The European Health Psychology Conference in Bath: Can We Bury the Idea That Psychotherapy Extends the survival of Cancer Patients?
Evidence-Based Practices & Nursing
Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
Background:
Heart failure is a major public health problem, and self-management is the primary approach to control the progression of heart failure. The low research participation rate among rural patients hinders the generation of new evidence for improving self-management in rural heart failure patients.
Purpose:
The purpose of this study is to identify the barriers and strategies in the recruitment and retention of rural heart failure patients in behavioral intervention programs to promote self-management adherence.
Method:
This is a descriptive study using data generated from a randomized controlled trial.
Results:
Eleven common barriers were identified such as the inability to perceive the benefits of the study, the burden of managing multiple comorbidities, and the lack of transportation to appointments. Possible gateways to improve recruitment and retention include using recruiters from the local community and promoting provider engagement with research activities. Multiple challenges inhibited rural heart failure patients from participating in and completing the behavioral intervention study.
Conclusion and implications:
Anticipation of those barriers, and identifying strategies to remove those barriers, could contribute to an improvement in the rural patients’ participation and completion rates, leading to the generation of new evidence and better generalizability of the evidence.
1PAGE 21. What is the question the authors are asking .docxfelicidaddinwoodie
1
PAGE
2
1. What is the question the authors are asking?
They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome.
2. Why do the authors believe this question is important?
According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome.
3. How do they try to answer this question?
They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at t ...
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
STUDY PROTOCOL Open AccessValues and options in cancer car.docx
CAPO 2016- printed
1. Bibliotherapy is a form of self-administered treatment that uses books to improve psychological
well-being. It is a low cost intervention with minimal demand on personnel resources.[1]
A substantial amount of research has shown the effectiveness of bibliotherapy for mental health
conditions, especially for mild to moderate levels of depression and anxiety symptoms.[1,2,3] Yet, only
a few studies have examined bibliotherapy as a method of reducing psychological distress in patients
with cancer despite its low cost and ease of accessibility.[4,5]
NUCARE is a psycho-educational, cognitive behavioral self-help intervention program for individuals
diagnosed with cancer. NUCARE focuses on the enhancement of a sense of personal control and the
learning of emotional and instrumental coping responses [4,5]. The secondary analyses presented on
this poster are based on a recent randomized controlled trial, which showed significantly greater
increases in empowerment and quality of life and decreases of distress in the bibliotherapy
group than in the control group comparing pre-intervention to follow-up assessment.[6,7]
Patient’s motivation to complete readings and to engage in intervention material are determining
factors for the effectiveness of bibliotherapy in alleviating mild to moderate psychological distress.[3]
Research Objectives:
Provide insight into the characteristics of patients interested in bibliotherapy.
Assess patients’ motivation to engage and adhere to the self-help program.
Participants
89 self-selected patients (Mage = 54 years, SD= 12) with heterogeneous cancer diagnoses and varying
tumour stages were recruited from two university-affiliated hospitals in Montréal, Canada.
No significant differences between the bibliotherapy and the control group conditions were found at
baseline for sociodemopgraphic, medical, and psychological variables.
Procedure
A mixed-method randomized control trial was conducted.
In addition to having access to care as usual, the intervention group participants were asked to
engage in the self-help workbook entitled: Mastering the art of coping in good times and bad[9].
The control group received usual care.
All participants were asked to complete a questionnaire package at recruitment (Time 1), six weeks
post-recruitment (Time 2) and ten weeks post-recruitment (Time 3).
The current study examines socio-demographics, illness-related variables, treatment motivation and
distress at Time 1, i.e., at pre-intervention, and treatment adherence at Time 2, i.e., immediately
post-intervention.
Measures
Sociodemographic and cancer-related information was gathered via self-report.
Motivation to engage in the coping intervention was assessed with the Treatment Self-Regulation
Questionnaire (TRSQ).[10]
Adherence to the intervention was measured by a questionnaire about the percentage of the book
that was read, the amount of time spent reading and engaging in the self-help material, and the
frequency with which participants practiced the prescribed interventions each weak.
Psychological distress, i.e., symptoms of anxiety and depression, was assessed with the Hospital
Anxiety and Depression Scale (HADS).[11]
INTRODUCTION
METHODS
Health Psychology
Research Group
Bibliotherapy has the potential to be a cost-effective minimal intervention that addresses
psychosocial needs of patients with cancer. It might be most appropriate to rely on bibliotherapy
when using a stepped-care approach that provides low-intensity interventions before more
intensive treatments are offered. Evidence-based bibliotherapy may reduce the burden on
health care resources and enhance the immediacy of psychosocial services.[6,7]
The findings regarding the efficacy of the NUCARE intervention program [6,7] and the here
presented analysis of sociodemographic, psychological and cancer-related sample
characteristics, speak for bibliotherapy as an intervention option for a broad range of patients
with cancer including males, older persons, individuals with high-school as their highest
educational degree, and patients with more advanced tumours as well as with newly diagnosed
malignancies.
When prescribing bibliotherapy, clinicians need to be sensitive to the level of depressive
symptomatology, which may get in the way of truly engaging with self-help materials.
Our study was limited by the small sample size, which did not allow us to detect smaller effects
or to examine causal relationships while controlling for other potential influences, e.g.,
determine if NUCARE was less effective for individuals who reported more depressive symptoms
and indicated less time engaging in the workbook.
CONCLUSION
DISCUSSION
REFERENCES:
1. Gregory RJ, Canning SS, Lee TW, Wise JC. Cognitive bibliotherapy for depression: A meta-analysis. Professional Psychology: Research and Practice 2004; 35: 275-280.
doi:10.1037/0735-7028.35.3.275
2. Fanner, D., & Urquhart, C. (2008). Bibliotherapy for mental health service users part 1: A systematic review. Health Information & Libraries Journal, 25, 237-252.
3. Marrs, R. (1995). A meta-analysis of bibliotherapy studies. American Journal of Community Psychology, 23, 843-870.
4. Rosberger, Z., Edgar, L., Collet, J., & Fournier, M. (2002). Patterns of Coping in Women Completing Treatment for Breast Cancer. Journal of Psychosocial Oncology, 20(3), 19-37.
5. Edgar, L., Rosberger, Z., & Collet, J. (2001). Lessons Learned: Outcomes and Methodology of a Coping Skills Intervention Trial Comparing Individual and Group Formats for Patients
with Cancer. International Journal of Psychiatry in Medicine, 31(3), 289-304.
6. Roberts, N., Steele, R., Rosberger, Z., Brosseau, D., & Körner, A. (2015). Bibliotherapy for patients with cancer: A randomized controlled trial. Manuscript submitted for publication.
7. Roberts, N., Lee, V., *Ananng, B., & Körner, A. (in press). Acceptability of bibliotherapy for patients with cancer: A qualitative descriptive study. Oncology Nursing Forum.
8. Naylor, E. V., Antonuccio, D., O., Litt, M., Johnson, G. E., Spogen, D. R., Williams, R., McCarthy, C., Lu,, M. M., Fiore, D. C., Higgins, D. L., (2008). Bibliotherapy as a treatment for
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Psychology, 70, 115-126.
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12. Faller, H. et al. (2013). Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. Journal of
Clinical Oncology, 31(6), 782-793.
13. Maunsell et al. (2014). Health-related empowerment in cancer: validity of scales from the health education impact questionnaire. Cancer, 3228-3236.
14. Singer et al. (2009). Hospital anxiety and depression scale cutoff scores for cancer patients in acute care. British Journal of Cancer, 100, 908 – 912.
15. Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2015). Canadian Cancer Statistics 2015. Toronto, ON: Canadian Cancer Society; 2015.
Sociodemographic
characteristics
Current sample
N=89
Other oncology samples
689 ≥ N ≤ 22,238
AGE
A
g
e
≤ 30 3 % 2 % [12]
31-50 31 % 20 % [12]
51-70 60 % 58 % [12]
≥ 71 6 % 21 % [12]
GENDER
Female 78 % 82 % [12]
Male 23 % 28 % [12]
YEARS OF EDUCATION
11-13 years (≤ high school) 24 % 43 % [13]
≥ 14 years (> high school) 45 % 54 % [13]
RELATIONSHIP STATUS
Single 57 % 75 % [13]
Not Single 43 % 24 % [13]
CANCER STAGE
Stage 0 2 % 2 % [14]
Stage 1 21 % 18 % [14]
Stage 2 18 % 22 % [14]
Stage 3 26 % 18 % [14]
Stage 4 8 % 10 % [14]
Missing/unknown 25 % 31 % [14]
90 %
72 %
82 %
62 %
55 %
46 %
62 %
0
10
20
30
40
50
60
70
80
90
100
Technique Type
PERCENTAGE%
Percentage of Patients Who Practiced the Prescribed
Intervention One or More Times per Week
Mindfulness Cognitive Reappraisal Relaxation Goal Setting
Problem Solving I-Statements Companionship
Table 1. Sociodemographic characteristics of the current study sample compared to
other oncology research samples.
The majority of patients interested in bibliotherapy were female, had completed an education
beyond high-school level, and were over 50 years of age. These characteristics are comparable to
other samples of patients partaking in psycho-oncological assessments or interventions.
However, the number of patients above 70 years of age was smaller in our bibliotherapy
sample.[12,13,14,15]
Patients with various cancer types and tumour stages were interested in bibliotherapy, which
also resembles the participants in other psychosocial oncology research. 35% of our participants
indicated to have been recently diagnosed with a new or a recurring cancer while 62% reported
having completed their treatment, and being in long-term follow-up, or under surveillance.
Participants indicated high autonomous motivation (MTRSQ at T1 = 5.8, SD = 1.3, possible range 1-
7). The most strongly endorsed reason for wanting to join this coping intervention program was:
“… it is very important for being as healthy as possible”, closely followed by “... wanting to take
responsibility for my own psychological well-being”.
Half of our participants reported clinically significant psychological distress, i.e., MHADS ≥ 13 in
51% of the cases. The mean HADS total score was 12.8 (SD= 6.1, Median = 14, Range: 1 to 29),
which is comparable to the mean of 13.6 (SD=7.8) in a sample of 689 patients with cancer.[14]
Participants completed between 25% and 100% of the book (M= 80%). 15% of our participants
read less than half the book. 52% of our sample completed the entire workbook. Participants
spent on average 57 minutes each week engaging in the self-help material (SD= 58). They most
frequently practiced mindfulness and relaxation techniques.
Patients with more depressive symptomology spent less time reading/engaging with the self-
help materials (rSpearman= -0.49, p < .05). Yet, depressive symptoms were unrelated to the
percentage of the book read (rSpearman=0.18, p=.36).
Motivation for the self-help intervention, i.e., the TRSQ total score, was neither related to the
weekly time spent engaging with the workbook nor to the percentage of the book read.
However, the more someone wanted to take responsibility for their own well-being, the more
often they sought social support.
A Self-help Program for Coping with Cancer
- Motivation for and Adherence to Bibliotherapy -
Bethsheba Ananng, BA1, Zofia Czajkowska, PhD Cand.1, Katelyn Ward, MA1, Nicole Roberts, PhD2, & Annett Körner, PhD1,2,3,4
1Department of Educational and Counselling Psychology, McGill University, Montréal; 2McGill Counselling Service , McGill University, Montréal;
3Louise Granofsky Psychosocial Oncology Program, Segal Cancer Centre - Jewish General Hospital, Montréal; 4Psychosocial Oncology Program, McGill University Health Centre, Montréal
RESULTS
ACKNOWLEDGMENT: The authors thank Tia Maric for her critical discussion of an early version of this poster.
CONTACT: annett.korner@mcgill.ca