RESUMEN
The diagnosis and treatment of cancer represents an experience that is potentially psychologically traumatizing for patients. However, cancer can contribute to the experience of positive psychological changes, namely posttraumatic growth. We conducted a review of empirical studies (n=44) on posttraumatic growth in cancer patients. We focused on the relations of posttraumatic growth to socio-demographic, medical, and psychological adjustment correlates. Results from forty-four reviewed articles indicated that age, gender, and ethnicity were consistently associated with posttraumatic growth in cancer. Regarding illness-related factors, the majority of relationships were positive and were found between subjective severity of cancer, chemotherapy, and experienced growth. The review revealed inconsistent relationships between indicators of psychological adjustment (emotional distress, posttraumatic stress symptoms, and quality of life) and perceived positive changes in the case of the cancer patients. Longitudinal studies might resolve this inconsistency by showing that posttraumatic growth has benefits for later psychological adjustment, as other studies have already documented.
Asunto(s)
Neoplasias/psicología , Crecimiento Psicológico Postraumático , Ajuste Emocional , Humanos , Calidad de VidaRESUMEN
Morningness-eveningness (chronotype) indicates the preferred time of intellectual and physical activity. This cross-sectional study had two main aims. The first aim was to explore associations among chronotype, quality of life, and relationship quality. The second aim of this study was to examine whether the similarities or discrepancies in chronotype between male and female members of the couples were linked to relationship quality. Both members of 143 couples (mean age = 39.44; SD = 10.11y) living together for at least 6 months completed measures of chronotype, marital stress, relationship satisfaction, dyadic coping, satisfaction with life, health-related quality of life, and quality of sleep. Variable-oriented (correlational) and person-oriented (cluster-analytic) analyses were conducted. Variable-oriented analyses showed that morningness was linked to better mental health, and fewer insomnia problems, but less frequent (self-perceived) stress communication for both genders. The discrepancy between the couple's chronotype scores was positively related to the women's sexual and general life satisfaction and more frequent (self-perceived) supportive dyadic coping by the partner. Moreover, ANOVA results showed that Evening-type (E-type) women had the highest mean score on sexual life satisfaction. According to cluster-analytic investigation, couples consisting of two morning-type members had the least frequent stress communication. On the other hand, these couples had better sleeping quality with less insomnia symptoms than couples with two E-type members. In summary, the present findings demonstrate that morningness holds both advantages and disadvantages for both general aspects of life and also the quality of relationships.
Asunto(s)
Ritmo Circadiano , Calidad de Vida , Estudios Transversales , Femenino , Humanos , Recién Nacido , Masculino , Sueño , Encuestas y CuestionariosRESUMEN
OBJECTIVE: This paper describes a randomized controlled single blind study testing the effects of a patient education intervention combined with positive therapeutic suggestions on anxiety for cataract surgery patients. METHODS: 84 patients participated in the study. Physiological and behavioral indicators of anxiety were compared between a regularly treated control and an intervention group receiving an audio CD containing information, relaxation, and positive imagery. RESULTS: We found that the intervention group was calmer throughout the four measurement points of the study (p=.004; d=0.71) and they were more cooperative (p=.01; d=0.60) during the operation. The groups did not differ in sleep quality before the day of the operation, heart rate during the procedure, and subjective Well-being. CONCLUSION: Findings indicate that preoperative information combined with positive suggestions and anxiety management techniques might reduce patient anxiety in the perioperative period of cataract surgery, but further research is needed to investigate the benefits of such interventions and to uncover the underlying mechanisms. PRACTICE IMPLICATIONS: Patient education interventions providing additional anxiety management techniques are recommended for use prior to cataract surgery.
Asunto(s)
Ansiedad/prevención & control , Extracción de Catarata/psicología , Educación del Paciente como Asunto/métodos , Cuidados Preoperatorios/métodos , Adulto , Anciano , Ansiedad/diagnóstico , Ansiedad/etiología , Catarata/psicología , Femenino , Humanos , Hungría , Imágenes en Psicoterapia , Masculino , Persona de Mediana Edad , Dolor Postoperatorio/psicología , Método Simple Ciego , Grabación en CintaRESUMEN
Fear of death, pain, or the recurrence of the illness of tumor patients can narrow their attention to a point where a spontaneous altered state of consciousness occurs. In these cases hypnosis either in formal psychotherapy or embedded into the everyday communication with the physician can effectively complement other already known medical and psychological techniques. Although numerous studies have reported the beneficial physical and mental changes induced by hypnosis, for a long time there were not enough research to affect evidence-based medicine. New studies meeting the most rigorous methodological standards, new reviews and the characteristics of hypnosis shown by neuroimaging techniques support the acceptance of this method. Hypnosis is used and studied with adult and child tumor patients alike mostly in the areas of anxiety, pain, nausea, vomiting, quality of life, mood amelioration, immune system and hot flushes. Most of the assays describe hypnosis as an empirically validated treatment technique that in most cases surpass attention diversion, coping trainings, cognitive behavior and relaxation techniques and other regular treatments. In this paper we review these observations.
Asunto(s)
Adaptación Psicológica , Analgesia/métodos , Ansiedad/terapia , Hipnosis , Oncología Médica/métodos , Oncología Médica/tendencias , Neoplasias/psicología , Analgesia/tendencias , Ansiedad/etiología , Ansiedad/prevención & control , Autosugestión , Miedo , Humanos , Hipnosis/métodos , Inmunidad , Náusea/terapia , Neoplasias/diagnóstico , Neoplasias/inmunología , Neoplasias/terapia , Periodo Perioperatorio , Radioterapia/psicología , Sugestión , Sobrevida , Cuidado Terminal/métodos , Cuidado Terminal/tendencias , Vómitos/prevención & controlRESUMEN
Besides more conventional tumor risks, depression and negative life events are significant risk factors in cancer here in Hungary, therefore oncopsychology is increasingly important. We discuss traumatizing effects of the diagnosis and invasive diagnostic and therapeutic procedures from the viewpoint of altered state of consciousness. During stress and hypnosis brain functioning is altered in a similar way, which can be seen both in the patient's symptoms and his/her physiological and neuroimaging findings. In trance state patients part from reality, they no longer communicate conventionally or maturely. Hypnosis is characterized not only by physical and mental changes, but important unique social interactions as well. These interactions affect the endocrine and immune system and the mental state of the patient, they strengthen and synchronize resources and help posttraumatic growth. Since in the stress induced spontaneous altered state of consciousness the susceptibility to suggestions is increased, suggestive communication can be used effectively and it can even result in formal hypnosis induction. Under the strong time and mental pressure characterizing the work of the oncologic departments, it might help the staff to improve the cooperation with the patient if staff members, physicians and nurses as well, are aware of the nature and the neurophysiologic background of the spontaneous trance state induced by the life-threatening diagnosis of cancer.
Asunto(s)
Estado de Conciencia , Hipnosis , Neoplasias/psicología , Neoplasias/terapia , Estrés Psicológico/etiología , Terapia Combinada , Depresión/complicaciones , Humanos , Acontecimientos que Cambian la Vida , Neoplasias/diagnóstico , Estrés Psicológico/terapia , SugestiónRESUMEN
PURPOSE: To compare the effectiveness for the patient of retrobulbar anaesthesia (RBA) and topical anaesthesia (TA) in cataract surgery by phacoemulsification. METHODS: We performed a prospective, randomized study on 115 patients operated at our clinic using the two anaesthesia techniques. The RBA group comprised 57 patients (20 women, 37 men; age 72 +/- 10 years); the TA group comprised 58 patients (20 women, 38 men; age 74 +/- 10 years). Measured parameters were: blood pressure; heart rate; blood oxygen saturation level; serum adrenaline, noradrenaline and cortisol levels; white blood cell count; indicated pain during the procedure, and pain as reported by the patient afterwards. Two psychological tests were used: the State-Trait Anxiety Inventory (STAI), and the patient-selected face-scale test. Statistical analysis was performed using Student's t-test and the chi-square test. Results were also analysed using a logistic regression model. RESULTS: Both types of anaesthesia were adequate for the surgical procedure. In the RBA group fewer patients experienced pain during surgery (p < 0.01) and fewer recalled any perioperative discomfort. With RBA the objective parameters were more stable than with TA, and systolic blood pressure was significantly lower (p = 0.01). The logistic model was able to predict perioperative pain with 93% certainty. Pain sensitivity was higher in younger patients and in patients with higher initial cortisol and noradrenaline serum levels. CONCLUSIONS: Both methods of anaesthesia are appropriate, but phacoemulsification with TA is more painful than with RBA. In hypertonic patients and younger patients who are more susceptible to pain, TA should be avoided or used in combination with individualized sedation.