Title [Study on the relationship between lung cancer at preclinic stage and psycho-social factor. A case-control study]. [Chinese] Source Chung-Hua Liu Hsing Ping Hsueh Tsa Chih Chinese Journal of Epidemiology. 18(5):289-92, 1997 Oct. MeSH Subject Headings Adenocarcinoma/ep [Epidemiology] Adenocarcinoma/px [Psychology] Aged Carcinoma, Squamous Cell/ep [Epidemiology] Carcinoma, Squamous Cell/px [Psychology] Case-Control Studies China/ep [Epidemiology] Depression *Emotions English Abstract Female Human *Lung Neoplasms/ep [Epidemiology] *Lung Neoplasms/px [Psychology] Male Middle Age Risk Factors Stress, Psychological Abstract A case-control study of primary lung cancer patients including 309 case (male 193, female 116) and 1,231 controls (male 768, female 463) was carried out in the monitored population for SINO-MONICA Project (WHO) during 1990-1993. This was a population based case-control study involved 0.75 million population in order to detect the relationship between lung cancer at preclinic stage and 6 psychosocial factors. There were 3 factors positively associated with lung cancer. They were 1) burst of "emotion and could not be controlled" (OR 1.82 P < 0.01), 2) "poor working circumstances" including poor relationship with colleagues (OR 1.37 P < 0.05) and superiors (OR 1.55 P < 0.01) and 3) the "depressive feeling for a long time" (OR 4.14 P < 0.01), when we considered "long standing depressive feeling" as a risk factor for lung cancer and calculated by an exposure rate of 8.8%, the population attributable risk percent (PAR%) would be 21.6% (male 18.7%, female 26.4%). Our findings suggested that the relationship between lung cancer at preclinic stage and psycho-social factor did exist. ISSN 0254-6450

Title Patient-reported short-term and long-term physical and psychologic symptoms: results of the continuous hyperfractionated accelerated [correction of acclerated] radiotherapy (CHART) randomized trial in non-small-cell lung cancer. CHART Steering Committee. Source Journal of Clinical Oncology. 16(9):3082-93, 1998 Sep. MeSH Subject Headings Anxiety/et [Etiology] *Carcinoma, Non-Small-Cell Lung/px [Psychology] *Carcinoma, Non-Small-Cell Lung/rt [Radiotherapy] Depression/et [Etiology] Human *Lung Neoplasms/px [Psychology] *Lung Neoplasms/rt [Radiotherapy] Patient Compliance Quality of Life *Radiotherapy/ae [Adverse Effects] Radiotherapy/mt [Methods] Statistics/mt [Methods] Time Factors Abstract PURPOSE: The randomized multicenter trial of continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy for patients with non-small-cell lung cancer (NSCLC) showed a significant survival benefit to CHART (29% v 20% at 2 years, P=.004). However, an assessment of the effect on physical and psychologic symptoms is vital to balance the costs and benefits of the two treatments. METHODS: A total of 356 patients in the United Kingdom completed the Rotterdam Symptom Checklist (RSCL) and the Hospital Anxiety and Depression Scale (HADS) at 10 time points. The principal aim of the analyses was to keep the methods simple, so as to allow the presentation and interpretation of the results to be as clear as possible. This was achieved by (1) considering individual symptoms rather than symptom subscales or domains, (2) assessing short-term effects (up to 3 months) and long-term effects (at 1 and 2 years) separately, and (3) for the short-term analyses, (a) splitting the data randomly into an exploratory data set and a confirmatory data set, and (b) using two different methods of analysis: a subject-specific approach, which used the area under the curve (AUC) as a summary measure, and a group-based method, which plotted the percent of patients with moderate or severe symptoms over time. RESULTS: The results indicate that apart from CHART causing transient pain on swallowing and heartburn, there was little difference between the regimens in the short or long-term. CONCLUSION: Combining the results of the patient-assessed symptom comparisons with the clinical results indicates that CHART confers a major benefit without serious morbidity. ISSN 0732-183X

Title Effectiveness of structured nursing assessment of symptom distress in advanced lung cancer. Source Oncology Nursing Forum. 25(6):1041-8, 1998 Jul. Local Messages CMC, 1988- MeSH Subject Headings Adult Aged Analysis of Variance Anxiety/et [Etiology] *Carcinoma, Non-Small-Cell Lung/co [Complications] Carcinoma, Non-Small-Cell Lung/dt [Drug Therapy] Carcinoma, Non-Small-Cell Lung/nu [Nursing] Carcinoma, Non-Small-Cell Lung/px [Psychology] *Carcinoma, Small Cell/co [Complications] Carcinoma, Small Cell/dt [Drug Therapy] Carcinoma, Small Cell/nu [Nursing] Carcinoma, Small Cell/px [Psychology] Depression/et [Etiology] Female Human Karnofsky Performance Status *Lung Neoplasms/co [Complications] Lung Neoplasms/dt [Drug Therapy] Lung Neoplasms/nu [Nursing] Lung Neoplasms/px [Psychology] Male Middle Age *Nursing Assessment/mt [Methods] *Oncologic Nursing/mt [Methods] Prospective Studies Support, Non-U.S. Gov't Weight Loss Abstract PURPOSE/OBJECTIVES: To test the efficacy of structured symptom assessment on level and rate of change in symptom distress over time. DESIGN: Prospective six-month randomized control trial. SETTING: Outpatient oncology offices and clinics in California. SAMPLE: 48 subjects newly diagnosed with advanced lung cancer, predominantly non-small cell. Most subjects received chemotherapy, 50% were women, and their average age was 62 years. 190 observations were analyzed. METHODS: Subjects were assigned randomly to structured assessment or usual care. Both groups completed the Symptom Distress Scale (SDS) monthly. After bivariate screening of potential predictors, a multivariate regression model for level and rate of change in SDS scores was created. MAIN RESEARCH VARIABLES: Symptom distress, functional status, and emotional distress. FINDINGS: Fatigue was the most common severely distressing symptom. In a multivariate model, chemotherapy and systematic assessment were associated with less symptom distress over time. Higher scores in depression and more functional limitations were related to higher levels of overall distress. Weight loss had a small impact. CONCLUSIONS: Systematic use of structured symptom assessment forestalled increased symptom distress over time. Chemotherapy lessened symptom distress, but the impact diminished with time. Subjects with more depression and greater functional limitations had greater symptom distress. IMPLICATIONS FOR NURSING PRACTICE: During the course of advanced lung cancer, systematic ongoing nursing assessment of symptoms may be the first step in enhancing interventions to decrease distress. Patients at highest risk for symptom distress are those who experience emotional distress and functional limitations. ISSN 0190-535X

Title Predictive factors for psychological distress in ambulatory lung cancer patients. Source Supportive Care in Cancer. 6(3):281-6, 1998 May. MeSH Subject Headings Adaptation, Psychological Adult Aged *Ambulatory Care/px [Psychology] Female Human Internal-External Control *Lung Neoplasms/px [Psychology] Male Middle Age *Palliative Care/px [Psychology] Personality Inventory *Sick Role Social Support *Stress, Psychological/co [Complications] Support, Non-U.S. Gov't Abstract Although there is a need for systematic research on the psychosocial issues faced by lung cancer patients, there have been few studies in this area. The objective of the present study was to investigate potential predictors of psychological distress among ambulatory lung cancer patients. The variables examined included the patients' characteristics, coping responses, and social support factors. Lung cancer patients completed the Profile of Mood States (POMS) and the Mental Adjustment to Cancer scale (MAC scale), and information pertaining to demographic variables and social support factors was obtained from them at a structured interview. Evaluable data were obtained from 87 patients. The results of multiple regression analysis indicated that female gender, living alone, no children in the role of confidant, nurses as confidants, and helplessness/hopelessness as a coping style were predictive for psychological distress. Information on patients' demographic variables and psychosocial correlates of psychological distress may later be useful in developing interventions to facilitate their adjustment to lung cancer. ISSN 0941-4355

Title Anxiety and depression in patients with lung cancer before and after diagnosis: findings from a population in Glasgow, Scotland. Source Journal of Epidemiology & Community Health. 52(3):203-4, 1998 Mar. Local Messages CMC, 1979- MeSH Subject Headings Adult Aged *Anxiety/et [Etiology] *Depression/et [Etiology] Female Human Lung Neoplasms/di [Diagnosis] *Lung Neoplasms/px [Psychology] Male Middle Age Prospective Studies Quality of Life Scotland/ep [Epidemiology] Statistics, Nonparametric Time Factors ISSN 0143-005X

Title [Psychiatric studies of chemotherapy and chemotherapy-induced nausea and vomiting of patients with lung or thymic cancer]. [Japanese] Source Gan to Kagaku Ryoho [Japanese Journal of Cancer & Chemotherapy]. 25(3):403-8, 1998 Feb. MeSH Subject Headings Aged *Antineoplastic Agents/ae [Adverse Effects] Depression English Abstract Female Human *Lung Neoplasms/dt [Drug Therapy] *Lung Neoplasms/px [Psychology] Male Manifest Anxiety Scale Middle Age *Nausea/ci [Chemically Induced] Personality Inventory Psychological Tests Quality of Life *Thymus Neoplasms/dt [Drug Therapy] *Thymus Neoplasms/px [Psychology] *Vomiting/ci [Chemically Induced] Abstract Psychiatric studies were made on 26 inoperable patients with lung cancer or thymic cancer to exam the possible correlation of chemotherapy and chemotherapy-induced nausea and vomiting. All patients were informed of their disease and how to undergo the therapy. Psychiatric tests of CMI (Cornell Medical, Index), MAS (Manifest Anxiety Scale), SDS (Self-Rating Depression Scale) and QOL questionnaire were performed just before the chemotherapy. SDS and QOL questionnaire were also done after chemotherapy. The patients were given chemotherapy including CDDP (80 mg/m2) and anti-emetic agents of 30 mg of azasetron, 750 mg of methylprednisolone and 1,800 mg of domperidone. The patients showing neurosis, anxiety or depression had significantly high nausea scores, so we concluded that psychiatric support was needed to improve these patients' QOL in chemotherapy. Registry Numbers 0 (Antineoplastic Agents). ISSN 0385-0684

Title Quality of life in patients with lung cancer: a review of literature from 1970 to 1995. Source Chest. 113(2):467-81, 1998 Feb. Local Messages CMC, 1970- MeSH Subject Headings Activities of Daily Living Carcinoma, Non-Small-Cell Lung/px [Psychology] Carcinoma, Non-Small-Cell Lung/th [Therapy] Carcinoma, Small Cell/px [Psychology] Carcinoma, Small Cell/th [Therapy] Clinical Trials Communication Emotions Epidemiologic Studies Follow-Up Studies Forecasting Human Karnofsky Performance Status *Lung Neoplasms/px [Psychology] Lung Neoplasms/th [Therapy] Outcome Assessment (Health Care) Palliative Care Patient Care Physician-Patient Relations Population Surveillance Prognosis Psychometrics *Quality of Life Questionnaires Reproducibility of Results Social Support Socioeconomic Factors Stress, Psychological/px [Psychology] Survival Rate Abstract A review of the literature was carried out covering the last 25 years (1970 to 1995) by searching through the MEDLINE and manually. The review consists of two companion parts. The first includes studies of quality of life in lung cancer patients in general, while the second part is restricted to defined samples of small and non-small cell lung cancer patients. Excluding non-English and review articles, in total 151 citations were identified and all have been reviewed. Over 50 instruments were used to measure quality of life in lung cancer studies. Of these, the European Organisation for Research and Treatment of Cancer Quality of Life Lung Cancer Questionnaire (EORTC QLQ-LC13) in conjunction with the core cancer questionnaire (QLQ-C30) was found to be the best developed instrument, although there were two other lung cancer-specific measures with good reliability and validity. Several topics in this chapter have been highlighted, including the importance of regularly measuring quality of life in lung cancer patients. Progress and achievements in areas such as performance status as a proxy of quality of life measure, psychological morbidity and symptom distress as predictive factors of quality of survival, and communication problems in quality of life studies of lung cancer patients have been emphasized and their implications in lung cancer care discussed. It is argued that palliation of symptoms, psychosocial interventions, and understanding patients' feelings and concerns all contribute to improving quality of life in lung cancer patients. It is concluded that the future challenge in treatment of lung cancer lies not only in improving the survival, but mainly the patients' quality of life regardless of cell type. Clinical trial and epidemiologic population-based outcome studies are recommended to provide this and to allow a better understanding of the contribution of the socioeconomic characteristics of the patients to their pretreatment and posttreatment quality of life. ISSN 0012-3692

Title [Do psychological factors modify survival of cancer patients? II: Results of an empirical study with bronchial carcinoma patients]. [German] Original Title Beeinflussen psychologische Faktoren die Uberlebenszeit bei Krebskranken? II: Ergebnisse einer empirischen Untersuchung mit Bronchialkarzinomkranken. Source Psychotherapie, Psychosomatik, Medizinische Psychologie. 47(6):206-18, 1997 Jun. MeSH Subject Headings *Adaptation, Psychological Adjustment Disorders/mo [Mortality] *Adjustment Disorders/px [Psychology] Adult Aged Aged, 80 and over Carcinoma, Bronchogenic/mo [Mortality] *Carcinoma, Bronchogenic/px [Psychology] Carcinoma, Non-Small-Cell Lung/mo [Mortality] Carcinoma, Non-Small-Cell Lung/px [Psychology] Carcinoma, Small Cell/mo [Mortality] Carcinoma, Small Cell/px [Psychology] English Abstract Female Follow-Up Studies Germany Human Lung Neoplasms/mo [Mortality] *Lung Neoplasms/px [Psychology] Male Middle Age Multivariate Analysis Prospective Studies Regression Analysis *Sick Role Support, Non-U.S. Gov't Survival Analysis Abstract The present prospective test study of hypotheses addressed the question whether psychological factors are predictive of survival time in lung cancer patients. The hypotheses were: Emotional distress, depression and depressive coping are associated with shorter survival; hope and active coping with longer survival. The study was based on a sample of n = 103 patients who were investigated post-diagnosis and before the beginning of primary treatment. Emotional distress and hope were assessed by clinical scales (self-reports and interviewer ratings), depression by the Depression Scale of von Zerssen, depressive coping and active coping by the Freiburg Questionnaire on Coping with illness by Muthny. At follow-up, which took place three to five years later, n = 74 patients had died, for n = 29 patients the survival data are censored. The prediction of the survival time was performed applying multivariate analyses (Kaplan-Meier-method, Cox-Regression), adjusting for biological risk factors (histological classification, stage of the disease, type and amount of treatment, Karnofsky performance status, age). Results were as follows: Active coping and hope were associated with longer survival, emotional distress, depression and depressive coping with shorter survival, respectively. These associations were found consistently across assessment methods. The predictive effects of coping and distress were statistically independent of the influence of the somatic risk factors. The best psychological predictor was the interviewer rating of active coping. Its predictive power equalled that of the Karnofsky performance status. However, there was evidence that the effects of the psychological factors varied somewhat in interaction with treatment modalities. The findings are discussed from a methodological perspective. Possible causal models and mechanisms are presented which could account for interactions of psychological measures and the course of the disease: Thus, it can be conceived that psychological effects were mediated by patients' compliance with medical treatment. In addition, it cannot be ruled out that psychological factors themselves were influenced by the physical status of the patients at the time of entry to the study. ISSN 0173-7937

Title A case study application of the Integrated Ethical/Clinical Judgment Model. Source Oncology Nursing Forum. 24(3):513-8, 1997 Apr. Local Messages CMC, 1988- MeSH Subject Headings Adaptation, Psychological Aged Case Report Decision Making *Ethics, Nursing Female *Hospice Care Human *Judgment *Lung Neoplasms/nu [Nursing] Male *Models, Nursing Nursing Methodology Research *Nursing Process Support, Non-U.S. Gov't *Widowhood/px [Psychology] Abstract PURPOSE/OBJECTIVES: To discuss diagnostic, therapeutic and ethical reasoning, as linked in the Gordon Murphy Candee and Hiltunen Integrated Clinical Judgment Model in the context of a case study. DATA SOURCES: An interview conducted with a widow who had been her husband's primary hospice caregiver while he was dying at home of lung cancer as well as published books and articles. DATA SYNTHESIS: Elements of ethical reasoning parties claims and moral basis for claims are revealed in the experiences of one family receiving hospice care. CONCLUSIONS: The Integrated Clinical Judgment Model has applicability in ethical research and clinical nursing practice. IMPLICATIONS FOR NURSING PRACTICE: Nurses firm grounding in both diagnostic and ethical reasoning will facilitate the application of sound clinical judgment in the provision of optimal hospice nursing care. ISSN 0190-535X

Title Mortality among Finnish sea pilots 1956-85: a retrospective cohort study. Source Occupational Medicine. 46(4):281-4, 1996 Aug. MeSH Subject Headings Adult Aged Cardiovascular Diseases/mo [Mortality] Cohort Studies Finland/ep [Epidemiology] Human Life Style Lung Neoplasms/mo [Mortality] Male Middle Age *Mortality Naval Medicine *Occupational Diseases/mo [Mortality] Retrospective Studies Risk Factors Stress, Psychological Abstract The National Board of Navigation in Finland employed 942 sea pilots in 1956-85, during which time 262 of them died (SMR = 77, 95% CI = 68-86). The male population in southwest Finland served as control. The causes of deaths were collected from death certificates. The mortality rate for all cardiovascular diseases and lung cancer was lower among sea pilots than in the comparison population (SMR = 83, 95% = CI 69-97 and SMR = 67, 95% CI = 37-97) while for ischaemic heart diseases, it was similar to that of the population as a whole (SMR = 96, 95% CI = 77-115). Health selection due to ischaemic heart disease was seen in the lower mortality rates among young pilots who started work in 1956-85. Otherwise, the slightly higher rates may indicate a possibility of adverse health effects of sea piloting. ISSN 0962-7480

Title A quantitative approach to the distress caused by symptoms in patients treated with radical radiotherapy. Source British Journal of Cancer. 74(4):640-7, 1996 Aug. Local Messages CMC, 1983- MeSH Subject Headings Adult Aged Aged, 80 and over Anxiety Breast Neoplasms/pa [Pathology] *Breast Neoplasms/rt [Radiotherapy] Breast Neoplasms/su [Surgery] Comparative Study Depression Female *Head and Neck Neoplasms/rt [Radiotherapy] Human *Lung Neoplasms/rt [Radiotherapy] Menopause Middle Age Neoplasm Staging *Pain Questionnaires *Radiotherapy/ae [Adverse Effects] Radiotherapy/mt [Methods] *Radiotherapy/px [Psychology] Regression Analysis Self Assessment (Psychology) Software *Stress, Psychological Support, Non-U.S. Gov't Abstract A computerised self-assessment instrument was used to capture data on the distress caused by symptoms in 110 patients treated with radical radiotherapy. Patients selected symptoms from a list of 34 problems and then quantified the distress associated with each problem using a linear Analogue self assessment (LASA)-type scale. The test instrument was feasible: 90% of assessments were completed in under 14 min. There was a significant increase in tiredness and significant decrease in anxiety and worries about the family, during treatment. Menopausal symptoms and post-surgical problems were important causes of distress in the patients with breast cancer. When the area under the curve method was used to quantify distress in the patients with breast cancer, difficulty concentrating, pain and sleep disturbances emerged as significantly troublesome problems. Computerised self-assessment may have a useful role in quantifying the distress caused by treatment with radiotherapy. ISSN 0007-0920

Title [Causal "cancer personality" attribution--an expression of maladaptive coping with illness?]. [German] Original Title Kausalattribution "Krebspersonlichkeit"--ein Ausdruck maladaptiver Krankheitsverarbeitung? Source Zeitschrift Fur Klinische Psychologie, Psychiatrie und Psychotherapie. 44(1):104-16, 1996. MeSH Subject Headings *Adaptation, Psychological Adult Aged Aged, 80 and over Carcinoma, Bronchogenic/px [Psychology] Causality Depressive Disorder/di [Diagnosis] Depressive Disorder/px [Psychology] English Abstract Female Human Internal-External Control Lung Neoplasms/px [Psychology] Male Middle Age Motivation *Neoplasms/px [Psychology] Personality Assessment Personality Disorders/di [Diagnosis] *Personality Disorders/px [Psychology] Risk Factors *Sick Role Support, Non-U.S. Gov't Abstract In psycho-oncology, the concept of a "cancer-prone personality" has gained some attention. This notion means that persons who try to stay pseudo-normal in spite of severe life stress, suppress negative emotions, particularly anger, and sacrifice themselves for other people without uttering any personal demands, are at a high risk to develop cancer. However, it has been demonstrated by previous research that features of the cancer-prone personality could only be found if the ill person was convinced to suffer from cancer, irrespective of what the factual diagnosis was. Thus it can be concluded that at least some aspects of the so called cancer personality might be the results of coping with the belief of having cancer. The present study had the objective to describe causal attributions to psychosocial factors in cancer patients, and to find out if these were connected with emotional state and coping. N = 120 newly diagnosed lung cancer patients were included in the study. The instruments consisted of a semi-structured interview, a check-list of subjective causal factors, self-reports and interviewer ratings on emotional state and standardised questionnaires about depression and coping. Patients who made a psychosocial causal attribution proved to suffer from greater emotional distress, to be more depressed and less hopeful than other patients. This difference seemed to be mediated by a depressive way of coping with the illness (brooding, wrangling). Thus, an attribution of the illness to psychological factors seems indicative of a maladaptive way of coping with illness. This result is supported by similar findings of previous research. The question is put up to discussion if the psychosomatic concept of a cancer personality may reflect patients' subjective theories which in turn may be the expression of their depressive coping modes. ISSN 0723-6557

<14> Unique Identifier 96210506 Authors Eysenck HJ. Institution Institute of Psychiatry, University of London, Denmark Hill, London SE5 8AF, England. Title Does smoking really kill anybody?. Source Psychological Reports. 77(3 Pt 2):1243-6, 1995 Dec. MeSH Subject Headings Causality *Cause of Death Data Interpretation, Statistical Female Human Lung Neoplasms/ge [Genetics] Lung Neoplasms/mo [Mortality] Lung Neoplasms/pc [Prevention & Control] Male Risk Factors Smoking/ae [Adverse Effects] *Smoking/mo [Mortality] Stress, Psychological/co [Complications] Abstract Statements that so many people are killed by smoking use the term "kill" in a very unusual manner which is easily misunderstood by people not expert in epidemiology. In addition, the usual calculations leave out of account the fact that smoking interacts synergistically with other risk factors, so that it is a combination of risk factors rather than any specific one that is likely to have a causal influence on mortality. Strictly speaking it is quite inappropriate to state that smoking kills anybody, if we use the term "kill" in a meaningful fashion. ISSN 0033-2941

<15> Unique Identifier 96099371 Authors Madison JL. Wilkie DJ. Institution Swedish Medical Center. Title Family members' perceptions of cancer pain. Comparisons with patient sensory report and by patient psychologic status. Source Nursing Clinics of North America. 30(4):625-45, 1995 Dec. Local Messages CMC, 1978- MeSH Subject Headings Adaptation, Psychological Adult Aged Aged, 80 and over *Attitude to Health Comparative Study Cross-Sectional Studies *Family/px [Psychology] Female Human Internal-External Control *Lung Neoplasms/pp [Physiopathology] Male Middle Age Nursing Methodology Research Pain/di [Diagnosis] Pain/et [Etiology] Pain/pc [Prevention & Control] *Pain/px [Psychology] *Pain Measurement Pilot Projects Questionnaires Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Abstract This study was the first to compare patient and family member perceptions of sensory pain and to describe the relationships between these perceptions and psychological factors in patients with lung cancer and pain. Our findings indicate that family members understand the patient's pain location about 75% of the time; however, family members rarely understand the patient's pain intensity, pain quality, or pain pattern. Our findings also indicate that family members tend to overestimate strategies used by patients to cope with pain, especially in patients with low levels of anxiety and in patients with an internal locus of control. Although findings from this study differ from some previous studies, our study provides additional data to suggest that discrepancies may exist between family member and patient perceptions of the cancer pain experience. Nurses need to be aware of potential discrepancies and to combine assessment information from both patients and family members when developing pain management interventions. ISSN 0029-6465

<16> Unique Identifier 96058811 Authors Faller H. Schilling S. Lang H. Institution Institute of Psychotherapy and Medical Psychology, University of Wurzburg, Germany. Title Causal attribution and adaptation among lung cancer patients. Source Journal of Psychosomatic Research. 39(5):619-27, 1995 Jul. MeSH Subject Headings *Adaptation, Psychological Adult Aged Aged, 80 and over Female Human *Internal-External Control Life Style *Lung Neoplasms/px [Psychology] Male Middle Age Occupational Exposure/ae [Adverse Effects] Personality Assessment *Sick Role Smoking/ae [Adverse Effects] Smoking/px [Psychology] Support, Non-U.S. Gov't Abstract The aim of the present study was to describe lung cancer patients' causal attributions and examine their associations with adaptation. Methods were based on semi-structured interview, content analysis, self-reports, interviewer ratings and standardized questionnaires. 'Smoking cigarettes' and 'toxins in the work place' were the most commonly mentioned possible causes. Patients who made a psychosocial causal attribution suffered greater emotional distress, were more depressed, and less hopeful than other patients. They were also more likely to be rated as showing a maladaptive way of coping with illness. The implications of these findings for psychosocial care are discussed. ISSN 0022-3999

<17> Unique Identifier 95323015 Authors Swenson C. Croy SF. Ahles TA. Loscalzo M. Wilkie DJ. Thompson GE. Title Multidisciplinary rounds. Pain assessment and management in a man with a history of alcoholism [clinical conference]. Source Cancer Practice. 3(3):130-3, 1995 May-Jun. MeSH Subject Headings *Alcoholism/co [Complications] *Carcinoma, Small Cell/co [Complications] Case Report Human *Lung Neoplasms/co [Complications] Male Middle Age *Nursing Assessment Pain/et [Etiology] *Pain/nu [Nursing] *Patient Care Planning Patient Care Team ISSN 1065-4704

<18> Unique Identifier 95300038 Authors Gold JH. Title Sex differences in psychologic symptoms among patients with newly diagnosed lung cancer [letter; comment]. Comments Comment on: Can Med Assoc J 1995 Mar 1;152(5):701-8 Source CMAJ. 152(12):1961-3, 1995 Jun 15. MeSH Subject Headings *Adaptation, Psychological Female Human *Lung Neoplasms/px [Psychology] Male Sex Factors ISSN 0820-3946

<19> Unique Identifier 95277729 Authors Gutman M. Singh RK. Xie K. Bucana CD. Fidler IJ. Institution Department of Cell Biology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA. Title Regulation of interleukin-8 expression in human melanoma cells by the organ environment. Source Cancer Research. 55(11):2470-5, 1995 Jun 1. Local Messages CMC, 1979- MeSH Subject Headings Adaptation, Psychological Animal Cell Communication/ph [Physiology] Cell Division/ph [Physiology] Female Human Interleukin-1/pd [Pharmacology] *Interleukin-8/bi [Biosynthesis] Interleukin-8/ge [Genetics] Keratinocytes/cy [Cytology] Liver Neoplasms, Experimental/me [Metabolism] Liver Neoplasms, Experimental/pa [Pathology] Liver Neoplasms, Experimental/sc [Secondary] Lung/ph [Physiology] Lung Neoplasms/me [Metabolism] Lung Neoplasms/pa [Pathology] Lung Neoplasms/sc [Secondary] Male *Melanoma/me [Metabolism] Melanoma/pa [Pathology] Melanoma/sc [Secondary] Mice Mice, Inbred BALB C Mice, Nude Middle Age Neoplasm Transplantation Organ Specificity RNA, Messenger/ge [Genetics] RNA, Messenger/me [Metabolism] Skin/ph [Physiology] *Skin Neoplasms/me [Metabolism] Skin Neoplasms/pa [Pathology] Skin Neoplasms/sc [Secondary] Skin Physiology Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Transforming Growth Factor beta/pd [Pharmacology] Abstract The in vitro expression level of interleukin-8 (IL-8) correlates with the metastatic potential of human melanoma cells. The purpose of this study was to determine whether the expression level of IL-8 in human melanoma cells is influenced by the organ microenvironment. A375P cells, a low metastatic human melanoma, and A375SM cells, a highly metastatic variant, were injected into the subcutis (s.c.), spleen (to produce liver metastases), and lateral tail vein (to produce lung metastases) of athymic nude mice. Northern blot and immunohistochemical analyses determined that s.c. tumors, lung lesions, and liver lesions expressed high, intermediate, and low IL-8, mRNA, and protein, respectively. This differential regulation of IL-8 was not due to the size or density of the lesions or to selection of subpopulations of cells. We based this conclusion on the results of three experiments: (a) melanoma cell lines established in culture from in vivo-growing tumors exhibited similar levels of IL-8 mRNA transcripts; (b) in a crossover experiment, the level of IL-8 mRNA was always high in A375 tumors reestablished in the skin and low in the tumors reestablished in the liver, regardless of whether the melanoma cells had been first harvested from s.c. or liver tumors; and (c) A375 melanoma cells cocultured with human keratinocytes produced high levels of IL-8 protein, whereas A375 cells cocultured with highly differentiated human hepatoma cells produced decreased levels. When A375P cells were then incubated with cytokines associated with keratinocytes (IL-1 and interferon beta) or hepatocytes (transforming growth factor alpha or beta), IL-1 enhanced the production of IL-8 protein, whereas TGF-beta decreased its production. These data show that IL-8 expression in melanoma cells is modulated by local host factors. Registry Numbers 0 (Interleukin-1). 0 (Interleukin-8). 0 (RNA, Messenger). 0 (Transforming Growth Factor beta). ISSN 0008-5472

<20> Unique Identifier 95312904 Authors Jahn I. Becker U. Jockel KH. Pohlabeln H. Institution Bremen Institute for Prevention Research and Social Medicine (BIPS), Germany. Title Occupational life course and lung cancer risk in men. Findings from a socio-epidemiological analysis of job-changing histories in a case-control study. Source Social Science & Medicine. 40(7):961-75, 1995 Apr. MeSH Subject Headings Adult Aged Case-Control Studies Cocarcinogenesis Germany/ep [Epidemiology] Human Job Satisfaction *Lung Neoplasms/ep [Epidemiology] Lung Neoplasms/et [Etiology] Male Middle Age *Occupational Diseases/ep [Epidemiology] Occupational Diseases/et [Etiology] *Occupational Exposure/ae [Adverse Effects] Risk Factors Socioeconomic Factors *Stress, Psychological/co [Complications] Support, Non-U.S. Gov't Abstract Psychosocial factors in general, and the social and psychological conditions of work and occupation in particular, have attracted little attention to the epidemiological investigation into the occupational-related causes of lung cancer. There is some evidence available concerning the impact of loss events--including job losses--on cancer development. During our research presented in this article, we examined job changes and job transitions in the occupational biography of men with regard to their circumstances in terms of (in-)voluntariness both as individual events and the job-changing histories of individuals. We expected the job-changing histories of lung cancer cases to be more involuntary than those of population controls, and vice versa. Our sample contains 391 male case-control pairs. Cases are defined as newly-diagnosed men of German nationality with a histologically- or cytologically-confirmed diagnosis of primary lung cancer. Population controls were drawn randomly from the municipality records of residents and individuals matched to cases 1:1 by age and region. Occupational histories were reconstructed, and information about other classical and suspected risk factors was collected during standardized interviews by trained interviewers. We categorized the reported reasons for job changes, and classified them with respect to voluntariness on a seven-stepped rating scale from -3 'very involuntary' to +3 'very voluntary', defining relations within the empirically established categories. The job-changing histories of individuals are described by using the average score of voluntariness. We measured the degree of voluntariness for the occupational history: (1) by the rounded average score; and (2) by the quintiles of the average score. On the basis of individuals matched odds ratios (OR) estimates are derived for the score of voluntariness unadjusted and adjusted for smoking, asbestos exposure and socio-economic group by conditional logistic regression. The investigation into job-changing histories using the average score of voluntariness lead to similar results for both measuring methods for the total study group. When the rounded score was used, job-changing histories which were assessed as 'very involuntary' and 'involuntary' (score -3 and -2) showed an elevated odds ratio of adjusted 1.41 (95%-CI: 0.57; 3.48), and when they were assessed as 'moderately involuntary' (score -1) the adjusted odds ratio was 1.59 (95%-CI: 1.02; 2.48), as compared with job-changing histories assessed as neutral (score 0). When the degree of voluntariness was measured by quintiles, the first quintile (score -3- < -0.6) showed an elevated risk of adjusted OR 1.36 (95%-CI: 0.79; 2.36) as compared to the third quintile (score -0.2- < -0.1).(ABSTRACT TRUNCATED AT 400 WORDS) ISSN 0277-9536

<21> Unique Identifier 95304886 Authors Faller H. Schilling S. Otteni M. Lang H. Institution Institut fur Psychotherapie und Medizinische Psychologie, Universitat Wurzburg. Title [Social support and social stress in tumor patients and their partners]. [German] Original Title Soziale Unterstutzung und soziale Belastung bei Tumorkranken und ihren Partnern. Source Zeitschrift fur Psychosomatische Medizin und Psychoanalyse. 41(2):141-57, 1995. MeSH Subject Headings Adaptation, Psychological Adult Aged Aged, 80 and over *Carcinoma, Bronchogenic/px [Psychology] Carcinoma, Non-Small-Cell Lung/px [Psychology] Carcinoma, Small Cell/px [Psychology] *Cost of Illness Cross-Sectional Studies English Abstract Female Human Longitudinal Studies *Lung Neoplasms/px [Psychology] Male *Marriage/px [Psychology] Middle Age Personality Inventory *Sick Role *Social Support Stress, Psychological/co [Complications] Abstract Social support is widely believed to be an important buffer against stress in patients coping with cancer. Support efforts can, however, in turn prove to become a source of distress in themselves, both in patients and support providers. The present study was designed to explore the connections between support and emotional distress. N = 120 lung cancer patients and their relatives (n = 57) are interviewed at three intervals. Social support is assessed by multiple methods: Content analysis, a questionnaire and a confidant rating performed by experts. Cross-sectional and longitudinal analyses are combined. Content-analytical and self-report data show a correlation of support efforts and emotional distress. In the confidant rating, however, the expected differences between supportive and non-supportive spousal relationships emerge. The results are discussed from an interactional point of view. ISSN 0340-5613

<22> Unique Identifier 95219353 Authors Feld R. Institution Department of Medicine, Princess Margaret Hospital, Toronto, Ontario, Canada. Title Recent advances in supportive care in patients with lung cancer. [Review] [55 refs] Source Lung Cancer. 11 Suppl 3:S101-10, 1994 Nov. MeSH Subject Headings Brain Neoplasms/pc [Prevention & Control] Depression/th [Therapy] Human *Lung Neoplasms/th [Therapy] Neutropenia/th [Therapy] Pain/th [Therapy] Vomiting/th [Therapy] ISSN 0169-5002

<23> Unique Identifier 95144123 Authors Hopwood P. Stephens RJ. Machin D. Institution CRC Psychological Medicine Group, Christie Hospital NHS Trust, Withington, Manchester, UK. Title Approaches to the analysis of quality of life data: experiences gained from a medical research council lung cancer working party palliative chemotherapy trial. Source Quality of Life Research. 3(5):339-52, 1994 Oct. MeSH Subject Headings *Antineoplastic Agents/tu [Therapeutic Use] Anxiety Carcinoma, Small Cell/dt [Drug Therapy] *Carcinoma, Small Cell/px [Psychology] *Data Interpretation, Statistical Depression Female Human Lung Neoplasms/dt [Drug Therapy] *Lung Neoplasms/px [Psychology] Male *Palliative Care/px [Psychology] *Quality of Life Questionnaires Support, Non-U.S. Gov't Abstract Standardization in the choice of quality of life (QOL) instruments and their application in randomised clinical trials have been advocated and generally accepted. However, there is now an urgent need to address the problems relating to the analysis and presentation of the data thus generated. There are intrinsic difficulties associated with QOL data, namely its multidimensional nature, attrition and missing data, and there is no consensus as to how these problems should be dealt with. This paper therefore considers these problems using interim data from a large Medical Research Council randomised trial in patients with small cell lung cancer and a poor prognosis, in which attrition and compliance are major concerns. Three possible approaches to the analysis of these data, which use different subsets of patients, are examined in detail. The strengths and weaknesses of these three methods are discussed, and examples of their use in the literature are given and compared with other reported approaches. The need for a standard definition of compliance is also emphasised, and a method of presentation suggested. The best current advice is that QOL data should be analysed in a number of different ways, and conclusions reached only when consistency is seen. Registry Numbers 0 (Antineoplastic Agents). ISSN 0962-9343

<24> Unique Identifier 95113091 Authors Steptoe A. Wardle J. Institution Department of Psychology, St. George's Hospital Medical School, University of London, UK. Title What the experts think: a European survey of expert opinion about the influence of lifestyle on health. Source European Journal of Epidemiology. 10(2):195-203, 1994 Apr. MeSH Subject Headings Alcohol Drinking/ae [Adverse Effects] *Attitude of Health Personnel Body Weight Breast Neoplasms/ep [Epidemiology] Breast Neoplasms/et [Etiology] Data Collection Diabetes Mellitus/ep [Epidemiology] Diabetes Mellitus/et [Etiology] Diet Epidemiology Europe/ep [Epidemiology] Exercise *Health Health Promotion Heart Diseases/ep [Epidemiology] Heart Diseases/et [Etiology] Human Hypertension/ep [Epidemiology] Hypertension/et [Etiology] *Life Style Lung Neoplasms/ep [Epidemiology] Lung Neoplasms/et [Etiology] *Physician Executives/px [Psychology] Public Health Risk Factors Smoking/ae [Adverse Effects] Social Medicine Stress, Psychological/co [Complications] Abstract This paper describes an assessment of expert medical and epidemiological opinion about the role of lifestyle in health, carried out by means of a questionnaire survey of senior members of academic departments of public health, epidemiology and social medicine in Western European universities. Estimates were made of the influence of eight lifestyle factors--smoking, alcohol consumption, exercise, stress, body weight, dietary fat, fibre and salt--on the aetiology or course of five disorders: heart disease, high blood pressure, lung cancer, breast cancer and diabetes. One hundred and fifty responses were received from scientists and clinicians from 16 countries. Respondents had an average of 17.8 years experience in their discipline (range 5-40 years). The only links to be endorsed as definite by over 90% of respondents were those between smoking and both heart disease and lung cancer. However, more than 70% considered alcohol consumption, exercise, stress body weight and dietary fat to be definite or probable influences on heart disease. Smoking, alcohol, exercise, stress, body weight and salt intake were endorsed as relevant to high blood pressure by more than 70%. Opinions differed widely about the influence of lifestyle on breast cancer and diabetes. Experts from the United Kingdom and Republic of Ireland were less positive than respondents from other countries about the influence of stress, dietary fat, fibre and salt on disease. The results indicate that comparatively few lifestyle factors were believed to be unequivocally related to any of the five disorders. Experts from the UK and Ireland were generally les likely to endorse lifestyle-disease links than those from other European countries.(ABSTRACT TRUNCATED AT 250 WORDS) ISSN 0393-2990

<25> Unique Identifier 95061552 Authors Klemm PR. Institution University of Delaware College of Nursing, Newark.

Title Variables influencing psychosocial adjustment in lung cancer: a preliminary study. Source Oncology Nursing Forum. 21(6):1059-62, 1994 Jul. Local Messages CMC, 1988- MeSH Subject Headings Activities of Daily Living *Adaptation, Psychological Adult Aged *Cost of Illness Female Human Lung Neoplasms/di [Diagnosis] Lung Neoplasms/nu [Nursing] *Lung Neoplasms/px [Psychology] Male Middle Age Neoplasm Staging Predictive Value of Tests Racial Stocks Sampling Studies Sickness Impact Profile Social Support Abstract PURPOSE/OBJECTIVES: To explore the relationships of daily hassles, demands of illness, and social support to the psychosocial adjustment of people with newly diagnosed, primary lung cancer. DESIGN: Descriptive correlational. SETTING: A regional oncology center located in a large teaching hospital. SAMPLE: 56 patients (62% male, 84% white, mean of 60 years old). METHODS: After being contacted by phone and assigned a functional status score, subjects completed and mailed four study tools: Hassles Scale, Demands of Illness Inventory, Personal Resource Questionnaire, and Patient Adjustment to Illness Scale-Self Report. MAIN RESEARCH VARIABLES: Daily hassles, demands of illness, social support, and psychosocial adjustment. FINDINGS: Demands of illness were predictive of psychosocial adjustment in the expected direction (i.e., higher scores were associated with decreased adjustment). Race also was a predictor. In general, participants reported relatively high social support, low hassles, moderately low demands of illness, and positive adjustment. CONCLUSIONS: Demands of illness were predictive of psychosocial adjustment in patients newly diagnosed with advanced lung cancer. IMPLICATIONS FOR NURSING PRACTICE: Demands of illness should be monitored at the time of diagnosis and periodically throughout the course of the disease. Interventions directed at specific types of demands can facilitate patient adjustment. ISSN 0190-535X

<26> Unique Identifier 95062878 Authors Faller H. Schilling S. Lang H. Institution Institut fur Psychotherapie und Medizinische Psychologie, Universitat Wurzburg. Title [Does coping improve emotional adjustment? Results of a longitudinal study with bronchial carcinoma patients]. [German] Original Title Verbessert coping das emotionale Befinden? Ergebnisse einer Langsschnittuntersuchung mit Bronchialkarzinompatienten. Source Psychotherapie, Psychosomatik, Medizinische Psychologie. 44(9-10):355-64, 1994 Sep-Oct. MeSH Subject Headings *Adaptation, Psychological Adult Aged Aged, 80 and over Carcinoma, Bronchogenic/mo [Mortality] *Carcinoma, Bronchogenic/px [Psychology] Carcinoma, Non-Small-Cell Lung/mo [Mortality] Carcinoma, Non-Small-Cell Lung/px [Psychology] Carcinoma, Small Cell/mo [Mortality] Carcinoma, Small Cell/px [Psychology] Defense Mechanisms English Abstract Female Follow-Up Studies Human Longitudinal Studies Lung Neoplasms/mo [Mortality] *Lung Neoplasms/px [Psychology] Male Middle Age *Sick Role Survival Rate Abstract Coping research has been able to identify some maladaptive coping behaviours, but only little is known about favorable modes of adaptation. These findings have raised the issue of circularity, i.e. the question as to whether depressive ways of coping are actually the cause or rather the effect of emotional distress, whether those correlations reflect different aspects of psychological distress, or, even worse, confounded measures. Cross-sectional correlations are unable to solve this problem. The present study applies cross-lagged multiple regression analysis within a panel design. N = 120 newly diagnosed lung cancer patients who were admitted to a large tumor centre are included in the sample. Patients are assessed by self-reports and interviewer-ratings on measures of psychological adjustment (distress, hope) and coping (active confrontation, arguing with one's fate, consolation, distancing) at three times: Time 1 pre-treatment, Time 2 post-treatment, Time 3 recurrence. Results pertaining to the course of the measures of adjustment and coping are presented. Systematic deteriorating effects can be reveiled only at time 3. Stability coefficients prove to be lower than expected, especially with respect to the longer time interval. The cross-lagged pane 1 design allows testing alternative causal models. The time 1- time 2 results show, that arguing with one's fate may lead to future emotional distress, whereas hope is connected with reduced future arguing with one's fate. These short term findings are confirmed in the prediction of the time 3-data. In addition, consolation seems to have a negative impact on hope in the long term.(ABSTRACT TRUNCATED AT 250 WORDS) ISSN 0173-7937

<27> Unique Identifier 94373347 Authors Hollen PJ. Gralla RJ. Kris MG. Cox C. Institution School of Nursing, University of Rochester, NY 14642. Title Quality of life during clinical trials: conceptual model for the Lung Cancer Symptom Scale (LCSS). [Review] [43 refs] Source Supportive Care in Cancer. 2(4):213-22, 1994 Jul. MeSH Subject Headings Activities of Daily Living Adult Aged Aged, 80 and over *Carcinoma, Non-Small-Cell Lung/dt [Drug Therapy] *Carcinoma, Non-Small-Cell Lung/pp [Physiopathology] *Clinical Trials Cough/pp [Physiopathology] Fatigue/pp [Physiopathology] Female Human Longitudinal Studies *Lung Neoplasms/dt [Drug Therapy] *Lung Neoplasms/pp [Physiopathology] Male Middle Age *Models, Biological *Models, Psychological Pain/pp [Physiopathology] *Quality of Life Stress/pp [Physiopathology] Support, Non-U.S. Gov't Abstract To appreciate the full benefits of treatment for lung cancer, especially in trials that fail to show improvements in survival, data recording the quality of life must be captured and refined to produce meaningful information. A conceptual model for quality of life for lung cancer patients was tested to obtain information about the dimensions of the quality-of-life construct for ongoing development and testing of a subjective measure for clinical trials. Using a longitudinal study design, the stability of predictive factors of the physical and functional dimensions of quality of life were examined using regression analysis. A patient-rated quality-of-life measure, the Lung Cancer Symptom Scale (LCSS), was administered to 144 non-small-cell lung cancer patients at baseline, day 29, and day 71 of a chemotherapy trial. The range of explained variance for all three components of the lung cancer model over three assessment points was as follows: symptomatic distress 41%-53%, activity status 48%-52%, and overall quality of life 35%-53%. The three dimensions fluctuated slightly during intervention, but were relatively stable factors across all three times of evaluation. The LCSS model explained nearly half of the variance for quality of life experienced by lung cancer patients during therapy with a new chemotherapeutic agent. These findings provide support that the physical and functional dimensions are important predictors of quality of life for individuals with lung cancer. Meaningful subjective quality-of-life data can be obtained to evaluate an intervention by using a disease- and site-specific quality-of-life measure for individuals with lung cancer, based on a reproducible conceptual model such as the LCSS, which is suitable for serial measurement for the progressive disease of lung cancer. [References: 43] ISSN 0941-4355

<28> Unique Identifier 94345034 Authors Middelboe T. Ovesen L. Mortensen EL. Bech P. Institution Department of Psychiatry, Bispebjerg University Hospital, Copenhagen, Denmark. Title Depressive symptoms in cancer patients undergoing chemotherapy: a psychometric analysis. Source Psychotherapy & Psychosomatics. 61(3-4):171-7, 1994. MeSH Subject Headings Adaptation, Psychological Adult Aged *Antineoplastic Agents/ae [Adverse Effects] Antineoplastic Agents/tu [Therapeutic Use] Breast Neoplasms/dt [Drug Therapy] Breast Neoplasms/px [Psychology] Carcinoma, Small Cell/dt [Drug Therapy] Carcinoma, Small Cell/px [Psychology] Depression/di [Diagnosis] *Depression/px [Psychology] Female Follow-Up Studies Human Lung Neoplasms/dt [Drug Therapy] Lung Neoplasms/px [Psychology] Male Middle Age Neoplasms/dt [Drug Therapy] *Neoplasms/px [Psychology] Ovarian Neoplasms/dt [Drug Therapy] Ovarian Neoplasms/px [Psychology] Personality Inventory/sn [Statistics & Numerical Data] Prospective Studies Psychometrics *Sick Role Support, Non-U.S. Gov't Abstract Depressive psychopathology was measured in a prospective follow-up study of 36 cancer patients. The psychometric properties of the Hamilton rating scales for depression and anxiety and the Melancholia Scale were examined. The scales proved useful, indicating that the symptomatic structure of depression in cancer patients is rather identical to that seen in primary depression. Depressive states were found in about 40% of patients before the start of chemotherapy. The frequency of intermediate and high scores on the depression scales showed a low to moderate decrease after 6 months. Aspects of depression in the medically ill are discussed, and screening routines suggested. Registry Numbers 0 (Antineoplastic Agents). ISSN 0033-3190

<29> Unique Identifier 94188760 Authors Colby JP Jr. Linsky AS. Straus MA. Institution Department of Sociology, University of New Hampshire, Durham 03824. Title Social stress and state-to-state differences in smoking and smoking related mortality in the United States. Source Social Science & Medicine. 38(2):373-81, 1994 Jan. MeSH Subject Headings Aged Female Human Lung Diseases, Obstructive/et [Etiology] *Lung Diseases, Obstructive/mo [Mortality] Lung Diseases, Obstructive/px [Psychology] Lung Neoplasms/et [Etiology] *Lung Neoplasms/mo [Mortality] Lung Neoplasms/px [Psychology] Male Middle Age Smoking/ae [Adverse Effects] *Smoking/ep [Epidemiology] Smoking/mo [Mortality] *Smoking/px [Psychology] *Stress, Psychological/ep [Epidemiology] Support, U.S. Gov't, P.H.S. United States/ep [Epidemiology] Abstract This paper reports on the relationship between the stressfulness of the social environment, smoking and mortality rates for malignant neoplasms of the respiratory system and chronic obstructive pulmonary disease (COPD). A macro-social approach was employed with the 50 states of the United States serving as the units of analysis. A 'State Stress Index' was computed using stressful events in 15 categories (divorce rate, business failures, natural disasters, etc.). Smoking behavior was measured by percentage smokers and the average cigarette sales per capita. Mortality rates for lung cancer and COPD were standardized by age. The percent population living in metropolitan areas, black, below poverty line, and with less than high school education were included as controls in the multiple regression analysis. The results show that populations that experience higher levels of stressful events smoke more heavily and eventually experience higher mortality from lung cancer and COPD. These relationships are robust: they are replicated for different time periods, for different measures of the independent and dependent variables, and with different analytic methods. The pattern of findings is consistent with a 'health behavior' model of stress in which populations under stress engage in behavior which is extremely inimical to health. ISSN 0277-9536

<30> Unique Identifier 94098945 Authors Faller H. Institution Institut fur Psychotherapie, Universitat Wurzburg. Title [Subjective illness theories: determinants or epiphenomena of coping with illness? A comparison of methods in patients with bronchial cancer]. [German] Original Title Subjektive Krankheitstheorien: Determinanten oder Epiphanomene der Krankheitsverarbeitung?Eine methodenvergleichende Utersuchung an Patienten mit Bronchialkarzimon. Source Zeitschrift fur Psychosomatische Medizin und Psychoanalyse. 39(4):356-74, 1993. MeSH Subject Headings *Adaptation, Psychological *Carcinoma, Bronchogenic/px [Psychology] *Carcinoma, Non-Small-Cell Lung/px [Psychology] *Carcinoma, Small Cell/px [Psychology] English Abstract Female Health Behavior Human *Lung Neoplasms/px [Psychology] Male Middle Age Personality Assessment *Sick Role Smoking/ae [Adverse Effects] Smoking/px [Psychology] Support, Non-U.S. Gov't Abstract The present paper analyzes subjective causal models in lung cancer patients. It addresses two questions: 1. What method is apt to assess subjective theories of illness? 2. What relationships can be found between subjective theories of illness on the one hand and emotional status and coping on the other hand. Subjective causes of the disease, assessed by a semi-structured interview and by a questionnaire respectively, are compared. Some connections with emotional status are tested. Univariate analyses show that certain causal models ("air pollution", "psychological cause") co-vary with emotional distress. This relationship, however, seems to be a result of a specific way of coping that works as a intervening variable, with which both subjective theory and emotional distress are confounded. The univariate connection can no longer be maintained when this way of coping is included in multivariate analysis. The question is discussed, whether subjective causal concepts may be determinants or epiphenomena of coping. ISSN 0340-5613

<31> Unique Identifier 94083274 Authors Bleehen NM. Girling DJ. Machin D. Stephens RJ. Title A randomised trial of three or six courses of etoposide cyclophosphamide methotrexate and vincristine or six courses of etoposide and ifosfamide in small cell lung cancer (SCLC). II: Quality of life. Medical Research Council Lung Cancer Working Party. Source British Journal of Cancer. 68(6):1157-66, 1993 Dec. Local Messages CMC, 1983- MeSH Subject Headings Adult Aged Anorexia/ci [Chemically Induced] Antineoplastic Agents, Combined/ad [Administration & Dosage] Antineoplastic Agents, Combined/ae [Adverse Effects] *Antineoplastic Agents, Combined/tu [Therapeutic Use] Anxiety *Carcinoma, Small Cell/dt [Drug Therapy] *Carcinoma, Small Cell/px [Psychology] Comparative Study Cyclophosphamide/ad [Administration & Dosage] Depression Dose-Response Relationship, Drug Drug Administration Schedule Etoposide/ad [Administration & Dosage] Female Human Ifosfamide/ad [Administration & Dosage] Infusions, Intravenous *Lung Neoplasms/dt [Drug Therapy] *Lung Neoplasms/px [Psychology] Male Medical Records Methotrexate/ad [Administration & Dosage] Middle Age Nausea/ci [Chemically Induced] Palliative Care Patient Compliance *Quality of Life Self Assessment (Psychology) Vincristine/ad [Administration & Dosage] Vomiting/ci [Chemically Induced] Abstract A total of 458 eligible patients, from 21 centres, with microscopically confirmed SCLC were allocated at random to three chemotherapy regimens, each given at 3-week intervals. In two regimens, etoposide, cyclophosphamide, methotrexate and vincristine were given for a total of either three courses (ECMV3) or six courses (ECMV6). In the third regimen, etoposide and ifosfamide were given for six courses (E16). Patients with limited disease also received radiotherapy to the primary site after the third course of chemotherapy in all three groups. As reported by clinicians, 59% of the ECMV3, 67% of the ECMV6 and 63% of the EI6 patients experienced moderate or severe adverse reactions to their chemotherapy. The major symptoms of disease, cough, haemoptysis, chest pain, anorexia, and dysphagia, were palliated in 63% or more of patients and the median duration of palliation was 63% or more of survival, the results being similar in the three groups. Among patients with poor overall condition, physical activity and breathlessness on admission, the proportions who improved were higher in the EI6 group but the differences were small. In all three groups, levels of anxiety fell substantially during treatment. Levels of depression were lower and showed little change. As assessed by patients using a daily diary card, the patterns of nausea, vomiting, activity and mood, associated with courses of chemotherapy were very similar in the three groups. In the EI6 group there was less dysphagia and better overall condition between courses, but these advantages need to be weighed against the inconvenience of the 24-h infusions required, compared with the 30-min infusions of the other two regimens. As reported in the companion paper (MRC Lung Cancer Working Party, 1993a) there was no statistically significant survival advantage to any of the three regimens, although the results do not exclude the possibility of a minor survival advantage with the two six-course regimens. In conclusion, there was no major clinical gain from continuing chemotherapy beyond three courses or from using the ifosfamide regimen. Registry Numbers 0 (Antineoplastic Agents, Combined). 33419-42-0 (Etoposide). 3778-73-2 (Ifosfamide). 50-18-0 (Cyclophosphamide). 57-22-7 (Vincristine). 59-05-2 (Methotrexate). ISSN 0007-0920

<32> Unique Identifier 93258293 Authors Sarna L. Institution School of Nursing, University of California, Los Angeles 90024-6918. Title Women with lung cancer: impact on quality of life. Source Quality of Life Research. 2(1):13-22, 1993 Feb. MeSH Subject Headings Activities of Daily Living Adult Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung/pp [Physiopathology] *Carcinoma, Non-Small-Cell Lung/px [Psychology] Carcinoma, Small Cell/pp [Physiopathology] *Carcinoma, Small Cell/px [Psychology] Female Human Lung Neoplasms/pp [Physiopathology] *Lung Neoplasms/px [Psychology] Middle Age *Quality of Life Questionnaires Stress, Psychological/ep [Epidemiology] Stress, Psychological/et [Etiology] Support, Non-U.S. Gov't Abstract The purpose of this study was to describe disruptions in quality of life (QOL) in women suffering from lung cancer, the leading cause of cancer-related death in the United States. QOL was measured with the CARES-SF. Symptom distress was measured with the modified Symptom Distress Scale, and functional status was measured with the Karnofsky Performance Status Scale. Sixty-nine women with lung cancer participated in a one-time data collection. The typical subject was under 65 years of age, married, has had primary or recurrent non-small cell lung cancer for over 12 months, had limited disease, and was not currently receiving treatment. Subjects had greater disruptions in global QOL and its dimensions compared to a normative heterogeneous female cancer sample. The most prevalent serious disruptions were fatigue, difficulty with household chores, worry about ability to care for self, and worry about cancer progression. The global CARES-SF score was moderately correlated to functional status (r = 0.69, p = < 0.001), and to symptom distress (r = 0.72, p = < 0.001). Symptom distress was associated strongly with the physical subscale of QOL (r = 0.80, p = 0.001) and significantly but less strongly with all other dimensions of QOL. Significantly greater differences in disruptions of quality of life occurred in women younger than 65 years (p = 0.04), women with recurrent disease (p = 0.003), and women with low income (p = 0.008). In stepwise regression, symptom distress predicted 53% of the variance followed by functional status (59%) and recurrence (63%) when QOL was the outcome variable. ISSN 0962-9343

<33> Unique Identifier 93181512 Authors Schwarz R. Institution Psychosoziale Nachsorgeeinrichtung fur Tumorkranke, Chirurgischen Universitatsklinik, Heidelberg. Title [Psychosocial factors in carcinogenesis: on the problem of the so-called cancer-prone personality]. [German] Original Title Psychosoziale Faktoren in der Karzinogenese: Zur Problematik der sogenannten Krebspersonlichkeit. Source Psychotherapie, Psychosomatik, Medizinische Psychologie. 43(1):1-9, 1993 Jan. MeSH Subject Headings Adaptation, Psychological Adolescence Adult Aged *Breast Neoplasms/px [Psychology] *Carcinoma, Bronchogenic/px [Psychology] Disease Susceptibility/px [Psychology] English Abstract Female Human *Lung Neoplasms/px [Psychology] Male Middle Age Personality Assessment *Personality Development Prospective Studies Risk Factors Sick Role Abstract Without distinguishing between the heterogeneous types of the disease which are implied in the term "cancer" a stereotype--the cancer-prone personality--is regarded as the essential cause of the disease. Their striking characteristics are quoted as follows: depressive mood, social conformity, restrained expression of needs and emotions, reduced perception of physical symptoms, etc. In a prebioptical prospective study, basing on semi-structured interviews carried out at two different points of time, with 230 women with breast tumours and 95 patients with a suspected lung cancer, the theory of a psychosocial cancer ethiology was examined with regard to the following aspects: do the psychological phenomena observed reflect a premorbide personality structure or do they represent reactions to the disease? Is it possible to register personality related phenomena in the preventive behaviour and are there specific differences in the perception of the symptoms? Through this quasi-experimental approach it was possible to distinguish between the influence of the personal expectancy concerning the diagnosis and the effect of the actual disease. This way it was proven that psychological phenomena of cancer patients are to be understood as the result and not as the cause of the disease. ISSN 0173-7937

<34> Unique Identifier 93133763 Authors Berckman KL. Austin JK. Institution Lander College, Greenwood, SC. Title Causal attribution, perceived control, and adjustment in patients with lung cancer [published erratum appears in Oncol Nurs Forum 1993 Apr;20(3):428] [see comments]. Comments Comment in: Oncol Nurs Forum 1993 Jul;20(6):851 Source Oncology Nursing Forum. 20(1):23-30, 1993 Jan-Feb. Local Messages CMC, 1988- MeSH Subject Headings *Adaptation, Psychological Adult Aged Aged, 80 and over *Attitude to Health Causality Female Human *Internal-External Control Lung Neoplasms/et [Etiology] Lung Neoplasms/nu [Nursing] *Lung Neoplasms/px [Psychology] Male Middle Age Models, Psychological Nursing Methodology Research Psychology, Social Abstract The relationships among causal attribution, perceived control, and adjustment to lung cancer were examined in 61 outpatients who had received a diagnosis of primary lung cancer. Data were collected using a structured interview and a self-report questionnaire. Both internal and external causal attributions were significantly positively correlated with perceived control. The relationship between internal causal attribution and perceived control was stronger. No significant relationships were found between perceived control and adjustment, although both internal and external causal attributions were significantly negatively correlated with aspects of adjustment. Recommendations are made for future research. ISSN 0190-535X

<35> Unique Identifier 93165858 Authors Faller H. Lang H. Schilling S. Wagner J. Institution Institut fur Psychotherapie und Medizinische Psychologie, Universitat Wurzburg. Title [Coping with illness in bronchial cancer from the viewpoint of the patients, their relatives and caregivers. A five-level assessment]. [German] Original Title Krankheitsverarbeitung bei Bronchialkarzinom aus der Sicht der Patienten, ihrer Angehorigen und der Betreuer. Eine Funf-Ebenen-Untersuchung. Source Psychotherapie, Psychosomatik, Medizinische Psychologie. 42(9-10):322-31, 1992 Sep-Oct. MeSH Subject Headings *Adaptation, Psychological Adult Aged Aged, 80 and over *Carcinoma, Bronchogenic/px [Psychology] Carcinoma, Non-Small-Cell Lung/px [Psychology] Carcinoma, Small Cell/px [Psychology] *Caregivers/px [Psychology] English Abstract *Family/px [Psychology] Female Human *Lung Neoplasms/px [Psychology] Male Middle Age Patient Care Team Physician-Patient Relations *Sick Role Social Support Abstract The investigation presented in this paper applies multi-level-assessment to emotional state and coping in patients with newly diagnosed bronchogenic carcinoma. Ratings are obtained by the patients themselves, their spouses/children, their physicians, their nurses, and interviewers, independently. Differences seem to override concordances. Patients generally present themselves in a more positive way, i. e. emotionally less disturbed, better adapted, and more successfully coping, than generally perceived by their associates. Discrepancies regarding specific aspects of illness recognition and coping give information about conflicts in both doctor-patient-relationship (e. g. greater amount of trust from the patients' than from the doctors' point of view) and nurse-patient-relationship (nurses claim patients being more aggressive then patients see themselves), as well as social support. Patients and relatives agree in their ratings of certain criteria of adaptation (getting along with the disease, quality of life) and in effective treatment possibilities. On the basis of factor analyses which are computed separately for each rating level, the perceptual structures of the different raters can be elaborated on. ISSN 0173-7937

<36> Unique Identifier 92375765 Authors Houston SJ. Kendall JA. Institution WJB Dorn Veterans Administration Hospital, Columbia, South Carolina. Title Psychosocial implications of lung cancer. Source Nursing Clinics of North America. 27(3):681-90, 1992 Sep. Local Messages CMC, 1978- MeSH Subject Headings Adaptation, Psychological Family Fear Human Lung Neoplasms/ec [Economics] Lung Neoplasms/nu [Nursing] *Lung Neoplasms/px [Psychology] Psychology, Social Quality of Life Social Support Stress, Psychological/nu [Nursing] Stress, Psychological/px [Psychology] Abstract Patients with lung cancer who are encouraged and permitted to verbalize their feelings by a staff that is interested, empathetic, and nonjudgmental are better able to overcome feelings of anxiety and fear, and they progress through the stages of the grieving process more easily. Communications between the lung cancer patient and the multidisciplinary staff should occur freely and without restraint. Unrealistic expectations made of the patient who is struggling to cope will almost certainly increase anxiety. Interventions must address coping responses of the patient and family living with lung cancer. Caregivers working with patients whose diagnoses are not favorable must examine their own feelings regarding terminal disease states and death before the entire cancer experience can be discussed openly and comfortably by the patient, family members, and health care team. The focus of care for families and patients living with lung cancer should be on care rather than cure. ISSN 0029-6465

<37> Unique Identifier 92349350 Authors Ell K. Nishimoto R. Mediansky L. Mantell J. Hamovitch M. Institution University of Southern California, School of Social Work, Los Angeles 90089-0411. Title Social relations, social support and survival among patients with cancer. Source Journal of Psychosomatic Research. 36(6):531-41, 1992 Sep. MeSH Subject Headings Adult Aged Breast Neoplasms/mo [Mortality] *Breast Neoplasms/px [Psychology] Colorectal Neoplasms/mo [Mortality] *Colorectal Neoplasms/px [Psychology] Female Human *Interpersonal Relations Lung Neoplasms/mo [Mortality] *Lung Neoplasms/px [Psychology] Male Marriage Middle Age Prospective Studies Risk Factors *Social Support Stress, Psychological Support, Non-U.S. Gov't Survival Analysis Abstract This study examined the relationship between social relationships and social support and survival following a first diagnosis of breast, colorectal, or lung cancer. Findings showed different factors related to survival for those with breast vs lung or colorectal cancer and for those with localized vs non-localized cancers. Results provide important evidence that social relations and social support may operate differently depending on cancer site and extent of disease. ISSN 0022-3999

<38> Unique Identifier 92238050 Authors Boeger A. Title [Coping with death by terminally ill patients in middle age]. [German] Original Title Bewaltigung des Todes bei terminal Erkrankten im mittleren Erwachsenenalter. Source Zeitschrift fur Gerontologie. 25(1):32-6, 1992 Jan-Feb. MeSH Subject Headings *Adaptation, Psychological *Attitude to Death Awareness *Carcinoma, Bronchogenic/px [Psychology] *Carcinoma, Small Cell/px [Psychology] English Abstract *Hemodialysis/px [Psychology] Human *Kidney Failure, Chronic/px [Psychology] *Leukemia, Myelocytic, Acute/px [Psychology] *Lung Neoplasms/px [Psychology] Middle Age Sick Role *Terminal Care/px [Psychology] Abstract Manners of coping with dying were studied in sixty patients with terminal diseases using explorative interviews. The reaction to impending death is commonly described in the literature as being reduced to only a few global dimensions. In contrast, a variety of reactions were found. Predominant were such cognitive restructuring as intellectual analysis and the emphasis of positive aspects. The manner of dealing with death and dying was also influenced by its proximity. Patients expecting to die soon or those with longer survival times (greater than 1 year) at the time of evaluation, hardly acknowledged or did not initiate discussion of their situation. ISSN 0044-281X

<39> Unique Identifier 92233052 Authors Wilkie DJ. Keefe FJ. Institution Department of Physiological Nursing, University of Washington, Seattle 98195. Title Coping strategies of patients with lung cancer-related pain. Source Clinical Journal of Pain. 7(4):292-9, 1991 Dec. MeSH Subject Headings *Adaptation, Psychological Adult Aged Aged, 80 and over Anxiety/px [Psychology] Female Human *Lung Neoplasms/pp [Physiopathology] Male Middle Age Pain Measurement Pain, Intractable/et [Etiology] *Pain, Intractable/px [Psychology] Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Abstract Previous findings in patients with nonmalignant pain indicate a relationship between pain coping strategies and psychological factors. Although coping strategies have been explored in patients with cancer pain, relationships with such factors have not been reported. We wished to examine relationships between selected pain and psychological variables and the use of pain coping strategies. Forty-five patients with pain related to lung cancer indicated how they expressed their pain to others and completed the McGill-Melzack Pain Questionnaire (MPQ), State-Trait Anxiety Inventory, Visual Analogue Scale of pain intensity, and the Coping Strategies Questionnaire (CSQ). Forty-two percent of the patients reported that they tried not to let others know they had pain, and 40% indicated they told others when they had pain. Preferences for not telling others was associated with more frequent pain coping attempts for all CSQ subscales but those of catastrophizing and reinterpreting pain sensation. State anxiety demonstrated positive correlation with catastrophizing coping strategies (r = 0.48) and negative correlation with ability to control (r = -0.50) and decrease (r = -0.50) pain. The number of pain sites was correlated with coping self-statements (r = 0.34). Pain intensity and state anxiety demonstrated similar relationships. Pain quality as measured with the MPQ demonstrated moderately strong correlation with diverting attention, praying and hoping, catastrophizing, and increased activity. Interventions aimed at reinforcing or expanding a patient's pain coping repertoire should be developed with consideration given to the patient's anxiety level, pain intensity, pain quality, and pain expression preference. ISSN 0749-8047

<40> Unique Identifier 92134815 Authors Bergman B. Sullivan M. Sorenson S. Institution Department of Pulmonary Medicine, University of Goteborg, Sweden. Title Quality of life during chemotherapy for small cell lung cancer. I. An evaluation with generic health measures. Source Acta Oncologica. 30(8):947-57, 1991. MeSH Subject Headings Adult Affect/de [Drug Effects] Aged Aged, 80 and over *Antineoplastic Agents, Combined/tu [Therapeutic Use] Anxiety/px [Psychology] *Carcinoma, Small Cell/dt [Drug Therapy] Carcinoma, Small Cell/px [Psychology] Depression/px [Psychology] Follow-Up Studies Human *Lung Neoplasms/dt [Drug Therapy] Lung Neoplasms/px [Psychology] Middle Age Prospective Studies *Quality of Life Support, Non-U.S. Gov't Abstract The Sickness Impact Profile (SIP) and the Hospital Anxiety and Depression scale (HAD) were used for assessment of physical and psychosocial functioning and emotional distress in patients with small cell lung cancer (SCLC) receiving chemotherapy. Treatment schedules extended over 12 months. Before treatment sixty-two patients, 36-80 years of age, completed the questionnaires and a selection of lung cancer symptom items. Approximately 50% of the patients reported clinically significant physical dysfunction, while emotional distress was reported by 25% and social restraints by 40%. Self-reported overall dysfunction, as assessed by SIP total index, was clinically significant in 60% of the patients. SIP physical and total indices were strongly related to WHO performance status (grade 0-4). The assessment was subsequently repeated every third month during the treatment period. Overall tumour response rate was 82%. The changes of physical and psychosocial functioning, as assessed by SIP, were significantly related to tumour response, although a persistent substantial overall dysfunction was shown among 50% of the responders after 3 months and among c. 40% after 6 months. In addition to tumour response, pain and appetite changes correlated with the change of overall SIP in multivariate analysis, implying the importance of pain control and appetite stimulating measures for patients with advanced cancer. Anxiety and depression, as measured by HAD, were reduced in 21 patients who completed 12 months chemotherapy, but only anxiety co-varied with tumour response. The results lend support to the use of the generic SIP and HAD as outcome measures in clinical research with SCLC patients receiving chemotherapy. Registry Numbers 0 (Antineoplastic Agents, Combined). ISSN 0284-186X

<41> Unique Identifier 92030534 Authors Maier GJ. Bertram M. Stephens S. Title Hospice-assisted deaths in a forensic facility: a comparison of patient reactions. Source American Journal of Hospice & Palliative Care. 8(3):15-22, 1991 May-Jun. Local Messages CMC, 1989- MeSH Subject Headings Adaptation, Psychological Adult *Attitude to Death Case Report Comparative Study Grief *Hospice Care/px [Psychology] Human Liver Neoplasms/px [Psychology] Liver Neoplasms/th [Therapy] Lung Neoplasms/px [Psychology] Lung Neoplasms/th [Therapy] Male Peer Group *Prisoners/px [Psychology] ISSN 1049-9091

<42> Unique Identifier 91277905 Authors Georgoff PB. Title The Rorschach with hospice cancer patients and surviving cancer patients. Source Journal of Personality Assessment. 56(2):218-26, 1991 Apr. MeSH Subject Headings Adaptation, Psychological Aged Aged, 80 and over Attitude to Death *Breast Neoplasms/px [Psychology] Defense Mechanisms Ego Female *Hospices Human *Lung Neoplasms/px [Psychology] Male Personality Development *Rorschach Test *Sick Role *Terminal Care/px [Psychology] Abstract Two groups, terminally ill hospice female lung and breast cancer patients and surviving female lung and breast cancer patients (mean age = 74.3 years), were given the Rorschach to discern the underlying personality structure. The hospice patients were found to be withdrawn, anxious, depressed, and unable to express their deep, fearful emotions. The surviving patients met life and death head-on and seemed richer for the experience. ISSN 0022-3891

<43> Unique Identifier 91156491 Authors French C. Title Individual fears. Care study. Source Nursing Times. 87(9):36-8, 1991 Feb 27-Mar 5. Local Messages CMC, 1983- MeSH Subject Headings Case Report *Fear Female Human *Lung Neoplasms/px [Psychology] Middle Age *Patient Care Planning Stress, Psychological/et [Etiology] *Stress, Psychological/nu [Nursing] Stress, Psychological/px [Psychology] ISSN 0954-7762

<44> Unique Identifier 91114414 Authors Bernhard J. Ganz PA. Institution Swiss Group for Epidemiologic and Clinical Cancer Research (SAKK), Bern, Switzerland. Title Psychosocial issues in lung cancer patients (Part 2). [Review] [43 refs] Source Chest. 99(2):480-5, 1991 Feb. Local Messages CMC, 1970- MeSH Subject Headings Cognition Fatigue/et [Etiology] Human Lung Neoplasms/co [Complications] Lung Neoplasms/mo [Mortality] *Lung Neoplasms/px [Psychology] Lung Neoplasms/th [Therapy] Quality of Life Sleep Disorders/et [Etiology] Stress, Psychological/et [Etiology] Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S. ISSN 0012-3692

<45> Unique Identifier 91085235 Authors Bernhard J. Ganz PA. Institution Swiss Group for Epidemiologic and Clinical Cancer Research (SAKK), Bern. Title Psychosocial issues in lung cancer patients (Part 1). [Review] [90 refs] Source Chest. 99(1):216-23, 1991 Jan. Local Messages CMC, 1970- MeSH Subject Headings Dyspnea/px [Psychology] Eating Disorders/px [Psychology] Human Incidence Lung Neoplasms/mo [Mortality] *Lung Neoplasms/px [Psychology] Pain/px [Psychology] Personality Sick Role Stress, Psychological Support, Non-U.S. Gov't Support, U.S. Gov't, Non-P.H.S. Vomiting, Anticipatory/px [Psychology] ISSN 0012-3692

<46> Unique Identifier 91095087 Authors Leverett P. Pickren JF. Wells C. Title Evelyn had plans--and they didn't include dying. Nursing grand rounds. Source Nursing. 20(11):44-9, 1990 Nov. MeSH Subject Headings Adaptation, Psychological Adult *Brain Neoplasms/nu [Nursing] *Carcinoma, Bronchogenic/co [Complications] Case Report Denial (Psychology) Female Human *Lung Neoplasms/co [Complications] Patient Care Planning Pregnancy *Pregnancy Complications, Neoplastic/nu [Nursing] Pregnancy Complications, Neoplastic/px [Psychology] Prognosis Terminal Care ISSN 0360-4039

<47> Unique Identifier 91050068 Authors Schmidt A. Weidenhammer W. Groll S. Institution Institut fur Klinische Forschung Hamburg. Title [Quality of life as a target variable in oncologic clinical research]. [German] Original Title Lebensqualitat als Zielvariable der onkologisch-klinischen Forschung. Source Zentralblatt fur Chirurgie. 115(13):793-800, 1990. MeSH Subject Headings Adult Aged Carcinoma, Non-Small-Cell Lung/px [Psychology] *Carcinoma, Non-Small-Cell Lung/th [Therapy] Depression/px [Psychology] English Abstract Female Follow-Up Studies Human Lung Neoplasms/px [Psychology] *Lung Neoplasms/th [Therapy] Male Middle Age Palliative Care/px [Psychology] *Palliative Care *Quality of Life Sick Role Abstract The change of target variables in palliative cancer treatment led to a new evaluation of quality of life. Its use as a target variable to discriminate different therapies is problematic. Investigations with a patient-questionnaire assessing quality of life showed that the validity of this term is difficult to judge. At present it should be used in clinical research as an accompanying variable only. ISSN 0044-409X

<48> Unique Identifier 90257241 Authors Hinds C. Institution University of Ottawa, School of Nursing, Canada. Title Personal and contextual factors predicting patients' reported quality of life: exploring congruency with Betty Neuman's assumptions. Source Journal of Advanced Nursing. 15(4):456-62, 1990 Apr. Local Messages CMC, 1989- MeSH Subject Headings Adaptation, Psychological Adult Aged Aged, 80 and over Chronic Disease Consumer Satisfaction Cross-Sectional Studies Family Female Human Internal-External Control Lung Neoplasms/nu [Nursing] *Lung Neoplasms/px [Psychology] Male Middle Age Models, Theoretical *Nursing Theory Patient Education Prognosis *Quality of Life Retrospective Studies Abstract The search for factors which influence seriously ill people's quality of life continues to generate both interest and research. A retrospective cross-sectional study was conducted among 87 patients with lung cancer who ranged between the ages of 38 and 82 years. The purposes of this investigation were to determine whether relationships existed between patients' preferences for illness-related information, their satisfaction with family functioning, their level of learned resourcefulness and their reported quality of life. This paper focuses on the results of a stepwise multiple regression analysis which identified seven factors, namely, prognosis, surgery, current radiotherapy, performance status, self-control skills (learned resourcefulness), preference for information and age-group, which accounted for 30% of explained variance in patients' reported quality of life. No single factor contributed a substantial amount of the variance in this sample's reported quality of life. This observation suggests differences in people's perceptions of these factors and their importance to them. These results support a conclusion that people's evaluation of their quality of life is subjective, changeable and depends on the circumstances they face. Congruence between the assumptions underlying Neuman's health care system model, and the personal and contextual nature of these seven factors in patients' quality of life are explored. These findings are relevant for practice. ISSN 0309-2402

<49> Unique Identifier 90208446 Authors Clark DB. Ram MD. MacDonald JS. Rees ED. Engelberg J. Noble RC. Institution Neurology Service, Department of Veterans Affairs Medical Center, Lexington, Ky. Title How physicians deal with their own impending death [clinical conference]. Source Southern Medical Journal. 83(4):441-7, 1990 Apr. MeSH Subject Headings Adaptation, Psychological *Attitude to Death Colonic Neoplasms/px [Psychology] *Decision Making Family/px [Psychology] Female Human Liver Neoplasms/px [Psychology] Lung Neoplasms/px [Psychology] Lung Neoplasms/rt [Radiotherapy] Male Pancreatic Neoplasms/px [Psychology] Pancreatic Neoplasms/th [Therapy] Patient Acceptance of Health Care Personality Philosophy, Medical *Physicians/px [Psychology] ISSN 0038-4348

<50> Unique Identifier 90049145 Authors Shapiro S. Title "Psychic stress" and lung cancer [letter]. Source Science. 246(4929):431-2, 1989 Oct 27. Local Messages CMC, 1973- MeSH Subject Headings Coronary Disease/et [Etiology] Human *Lung Neoplasms/et [Etiology] Smoking/ae [Adverse Effects] *Stress, Psychological/co [Complications] ISSN 0036-8075

<51> Unique Identifier 89311905 Authors Homma T. Yoshida S. Yoneda S. Noguchi Y. Yoshii A. Hibino S. Ishiguro S. Institution Pulmonary Medicine Clinic, Saitama Cancer Center. Title [The clinical picture of terminally ill patients with lung cancer]. [Japanese] Source Gan No Rinsho - Japanese Journal of Cancer Clinics. 35(8):891-4, 1989 Jul. MeSH Subject Headings Adult Aged Aged, 80 and over Anxiety Cause of Death Combined Modality Therapy Delirium Depression English Abstract Female Human Lung Neoplasms/mo [Mortality] Lung Neoplasms/px [Psychology] *Lung Neoplasms/th [Therapy] Male Middle Age Morphine/tu [Therapeutic Use] Oxygen Inhalation Therapy Parenteral Nutrition, Total Respiratory Insufficiency/mo [Mortality] Social Support *Terminal Care/mt [Methods] Abstract An investigation has been made with regard to the clinical picture of 87 terminally ill patients with lung cancer. It has yielded the following points. 1) Seven patients had been informed of their diagnosis. 2) Intravenous hyperalimentation was administered in 78 cases (90%), oxygen therapy in 68 cases (78%), and morphine in 35 cases (40%). 3) The most frequent cause of death in these patients was respiratory failure, due to progress of cancer, then infection, pleural, or pericardial effusion, or interstitial pneumonitis. 4) Psychic disturbances involved anxiety over breathing, depression, and delirium. In only 12% of the patients did the mental condition seem normal until death. 5) To deal with the dying patient's needs, it is necessary to establish proper treatment for the control of sensory dyspnea and for psychosocial support by a psychiatrist and other professionals for members of the family. Registry Numbers 57-27-2 (Morphine). ISSN 0021-4949

<52> Unique Identifier 89178239 Authors Ell K. Nishimoto R. Mantell J. Hamovitch M. Institution University of Southern California, School of Social Work, Los Angeles 90089-0411. Title Longitudinal analysis of psychological adaptation among family members of patients with cancer. Source Journal of Psychosomatic Research. 32(4-5):429-38, 1988. MeSH Subject Headings *Adaptation, Psychological Adult *Breast Neoplasms/px [Psychology] *Colorectal Neoplasms/px [Psychology] *Family Female Follow-Up Studies Human Longitudinal Studies *Lung Neoplasms/px [Psychology] Male Psychological Tests *Sick Role Support, Non-U.S. Gov't Abstract A growing body of research suggests that a cancer diagnosis reverberates throughout the family system. The majority of studies provide evidence of the psychological distress experienced by family members at the time of diagnosis and during terminal and early bereavement stages. Increasingly, however, patients survive a cancer diagnosis. Therefore, their experience and that of family members more closely approximates living with a chronic illness. In this longitudinal study of 143 pairs of patients and significant others it was found that a substantial minority of significant others experienced psychological distress up to one year after the patient's initial diagnosis. The psychologically vulnerable group of significant others included an initially poor functioning group who remained so over time as well as a group whose mental health status declined over time. Personal and social resources were more important factors in declining mental health than illness-related factors. ISSN 0022-3999

<53> Unique Identifier 88256516 Authors Graydon JE. Institution Faculty of Nursing, University of Toronto, Ontario, Canada. Title Factors that predict patients' functioning following treatment for cancer. Source International Journal of Nursing Studies. 25(2):117-24, 1988. Local Messages CMC, 1987- MeSH Subject Headings Adaptation, Psychological Adult Aged Anxiety *Breast Neoplasms/px [Psychology] Breast Neoplasms/rt [Radiotherapy] Female Human Interviews *Lung Neoplasms/px [Psychology] Lung Neoplasms/rt [Radiotherapy] Male Middle Age Probability Psychological Tests Social Support *Stress, Psychological/px [Psychology] Abstract The study assessed whether the extent of cancer patients' functioning following a course of radiotherapy could be predicted from the amounts of concern, emotional distress, social support and symptoms they had when they began the treatments and from the number of unanticipated experiences they had related to receiving radiotherapy. A sample of 79 patients, 58 with breast cancer and 21 with lung cancer, were interviewed at the beginning and following a course of radiotherapy. When their diagnosis and age were controlled statistically, the only variable which predicted the subject's functioning following the radiotherapy was the amount of emotional distress they experienced when they began the treatments. An examination of the extent to which the individual components of emotional distress contributed to the subjects' functioning revealed that the tension-anxiety component of the emotional distress score was the best predictor of their functioning. ISSN 0020-7489

<54> Unique Identifier 88104353 Authors Gantt R. Lincoln JE. Title Marriage to a smoker and lung cancer risk [letter]. Source American Journal of Public Health. 78(1):99-100, 1988 Jan. Local Messages CMC, 1962- MeSH Subject Headings Female Human *Lung Neoplasms/et [Etiology] Male *Marriage Risk Factors *Smoking/ae [Adverse Effects] *Stress, Psychological/et [Etiology] ISSN 0090-0036

<55> Unique Identifier 88119758 Authors Saunders JM. McCorkle R. Title [Social support and coping with lung cancer]. [Japanese] Source Kango Kenkyu - Japanese Journal of Nursing Research. 20(4):343-50, 1987 Summer. MeSH Subject Headings *Adaptation, Psychological Human Lung Neoplasms/pp [Physiopathology] *Lung Neoplasms/px [Psychology] Pain/px [Psychology] *Social Environment *Social Support ISSN 0022-8370

<56> Unique Identifier 87301302 Authors Cella DF. Orofiamma B. Holland JC. Silberfarb PM. Tross S. Feldstein M. Perry M. Maurer LH. Comis R. Orav EJ. Title The relationship of psychological distress, extent of disease, and performance status in patients with lung cancer. Source Cancer. 60(7):1661-7, 1987 Oct 1. Local Messages CMC, 1976- MeSH Subject Headings Adult Age Factors Aged Education Emotions Female Human Lung Neoplasms/co [Complications] Lung Neoplasms/pa [Pathology] *Lung Neoplasms/px [Psychology] Male Marriage Middle Age Sex Factors *Stress, Psychological/co [Complications] Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S. Abstract This study examined the association between two primary covariates, extent of disease (ED) and performance status rating (PSR), and the outcome of psychological distress in patients with small cell carcinoma of the lung. Patients were studied at the time of entry onto one of three Cancer and Leukemia Group B (CALGB) protocols: 7781 (N = 165) and 8083 (N = 139) for limited disease; and 7782 (N = 151) for extensive disease. Besides ED (limited versus extensive), a four-point rating of PSR was obtained. Psychological distress was measured by the standardized Profile of Mood States (POMS). Gender, age, marital status, education, PSR, ED and two relevant interaction terms (PSR X ED; gender X ED) were analyzed using multiple linear and hierarchical regressions. Of the six main variables, gender and PSR had significant association with POMS total mood disturbance, a summary score for POMS emotional subscales, and most of the individual subscales. The PSR X ED interaction provided a rationale for testing a new regression model in which PSR and ED were combined into a single index of impairment. The final index resulted in five levels of physical impairment which bear an approximately linear relationship to increasing levels of distress (Overall regression, P less than 0.001). These data suggest that PSR is an important factor in modelling POMS distress at both levels of ED, and that ED becomes an important factor with poorer performance status only. ISSN 0008-543X

<57> Unique Identifier 87291335 Authors Ryan LS. Title Lung cancer: psychosocial implications. Source Seminars in Oncology Nursing. 3(3):222-7, 1987 Aug. MeSH Subject Headings Antineoplastic Agents/ae [Adverse Effects] *Depression/px [Psychology] Human *Lung Neoplasms/px [Psychology] Mental Processes/de [Drug Effects] Professional-Family Relations Social Support Registry Numbers 0 (Antineoplastic Agents). ISSN 0749-2081

<58> Unique Identifier 87285613 Authors Tanibuchi M. Title [Psychological nursing of patients with lung cancer]. [Japanese] Source Kurinikaru Sutadi - Clinical Study. 8(7):657-60, 1987 Jul. MeSH Subject Headings *Adaptation, Psychological Human *Lung Neoplasms/nu [Nursing] Lung Neoplasms/px [Psychology] ISSN 0388-5585

<59> Unique Identifier 87236411 Authors Saunders JM. McCorkle R. Title Social support and coping with lung cancer. Source Western Journal of Nursing Research. 9(1):29-42, 1987 Feb. MeSH Subject Headings *Adaptation, Psychological Case Report Family Female Human *Lung Neoplasms/px [Psychology] Middle Age *Social Environment *Social Support Stress, Psychological/px [Psychology] Support, U.S. Gov't, P.H.S. ISSN 0193-9459

<60> Unique Identifier 86318386 Authors Gadalov VP. Kuz'mina EG. Fedotova LIa. Burenkova LK. Smirnova NA. Title [Effect of ketamine anesthesia and stress due to bronchoscopy on immunity indices of cancer and noncancer patients]. [Russian] Original Title Vliianie ketaminovoi anestezii i stressa, obuslovlennogo bronkhoskopiei, na nekotorye pokazateli immuniteta onkologicheskikh i neonkologicheskikh bol'nykh. Source Vestnik Akademii Meditsinskikh Nauk SSSR. (6):91-5, 1986. MeSH Subject Headings Adult Aged *Anesthesia/ae [Adverse Effects] Antibody Formation B-Lymphocytes/im [Immunology] *Bronchoscopy/ae [Adverse Effects] Chronic Disease Comparative Study English Abstract Female Human Immunity, Cellular Injections, Intramuscular *Ketamine Leukocyte Count *Lung Diseases/im [Immunology] *Lung Neoplasms/im [Immunology] Male Middle Age Stress, Psychological/et [Etiology] *Stress, Psychological/im [Immunology] T-Lymphocytes/im [Immunology] Registry Numbers 6740-88-1 (Ketamine). ISSN 0002-3027

<61> Unique Identifier 86318385 Authors Neprina GS. Gadalov VP. Panteleeva ES. Vatin OE. Shakhtarin VV. Title [Effect of hexenal anesthesia and stress due to bronchoscopy on immunity indices in cancer and noncancer patients]. [Russian] Original Title Vliianie geksenalovoi anestezii i stressa, obuslovlennogo bronkhoskopiei, na kekotorye pokazateli immuniteta onkologicheskikh i neonkologicheskikh bol'nykh. Source Vestnik Akademii Meditsinskikh Nauk SSSR. (6):87-91, 1986. MeSH Subject Headings *Anesthesia, Intravenous/ae [Adverse Effects] Antibody Formation B-Lymphocytes/im [Immunology] *Bronchoscopy/ae [Adverse Effects] Chronic Disease English Abstract Female *Hexobarbital Human Immunity, Cellular Leukocyte Count *Lung Diseases/im [Immunology] *Lung Neoplasms/im [Immunology] Male Middle Age Stress, Psychological/et [Etiology] *Stress, Psychological/im [Immunology] T-Lymphocytes/im [Immunology] Registry Numbers 56-29-1 (Hexobarbital). ISSN 0002-3027

<62> Unique Identifier 86313090 Authors Brown ML. Carrieri V. Janson-Bjerklie. Dodd MJ. Title Lung cancer and dyspnea: the patient's perception. Source Oncology Nursing Forum. 13(5):19-24, 1986 Sep-Oct. Local Messages CMC, 1988- MeSH Subject Headings *Adaptation, Psychological *Dyspnea/pp [Physiopathology] Dyspnea/px [Psychology] Human *Lung Neoplasms/pp [Physiopathology] Lung Neoplasms/px [Psychology] Patient Education Questionnaires ISSN 0190-535X

<63> Unique Identifier 86217718 Authors Kesselring A. Dodd MJ. Lindsey AM. Strauss AL. Title Attitude of patients living in Switzerland about cancer and its treatment. Source Cancer Nursing. 9(2):77-85, 1986 Apr. Local Messages CMC, 1988- MeSH Subject Headings *Adaptation, Psychological Adult Aged *Attitude to Health *Breast Neoplasms/px [Psychology] Comparative Study Cross-Cultural Comparison Egypt Family Female Human *Life Change Events *Lung Neoplasms/px [Psychology] Male Middle Age Questionnaires Role Switzerland Taiwan ISSN 0162-220X

<64> Unique Identifier 85083854 Authors Ishii M. Maruyama F. Hirata F. Title [Involvement of nurses in the dying process of patients--nursing of a distressed patient with lung cancer who was aware of the nature of his illness]. [Japanese] Source Kangogaku Zasshi - Japanese Journal of Nursing. 48(12):1361-5, 1984 Dec. MeSH Subject Headings Aged *Attitude to Death Case Report Human *Lung Neoplasms/nu [Nursing] Lung Neoplasms/px [Psychology] Male Stress, Psychological *Terminal Care ISSN 0386-9830

<65> Unique Identifier 85061406 Authors Mack RM. Title Lessons from living with cancer. Source New England Journal of Medicine. 311(25):1640-4, 1984 Dec 20. Local Messages CMC, 1964- MeSH Subject Headings *Adaptation, Psychological *Attitude to Death Case Report Counseling Human *Lung Neoplasms/px [Psychology] Male Middle Age Surgery ISSN 0028-4793

<66> Unique Identifier 84290612 Authors Cooper CL. Title The social-psychological precursors to cancer. Source Journal of Human Stress. 10(1):4-11, 1984 Spring. MeSH Subject Headings Adaptation, Psychological Breast Neoplasms/px [Psychology] Female Human Life Change Events Lung Neoplasms/px [Psychology] Male *Neoplasms/px [Psychology] Personality *Psychophysiologic Disorders/px [Psychology] Risk *Stress, Psychological/co [Complications] Abstract This article attempts to review the research literature relating the possible psychosocial precursors to cancer. It explores the evidence linking personality predispositions and adverse life events to cancer, providing an indication of where future research should be pursued. ISSN 0097-840X

<67> Unique Identifier 84205352 Authors Heinrich RL. Schag CC. Title A behavioral medicine approach to coping with cancer: a case report. Source Cancer Nursing. 7(3):243-7, 1984 Jun. Local Messages CMC, 1988- MeSH Subject Headings *Adaptation, Psychological Behavioral Medicine *Carcinoma, Small Cell/px [Psychology] Carcinoma, Small Cell/th [Therapy] Case Report Crisis Intervention Family Female Human *Life Change Events *Lung Neoplasms/px [Psychology] Lung Neoplasms/th [Therapy] Male Middle Age Support, U.S. Gov't, P.H.S. ISSN 0162-220X

<68> Unique Identifier 84040742 Authors Newton JJ. Title Indulging .. to the point of destruction. Source Ohio State Medical Journal. 79(6):415-7, 1983 Jun. MeSH Subject Headings *Alcoholism/co [Complications] Coronary Disease/et [Etiology] Female Fetal Alcohol Syndrome/et [Etiology] Health Promotion Human Lung Neoplasms/et [Etiology] Male Pregnancy *Stress, Psychological/co [Complications] *Tobacco Use Disorder/co [Complications] ISSN 0030-1124

<69> Unique Identifier 83195585 Authors Wellisch D. Landsverk J. Guidera K. Pasnau RO. Fawzy F. Title Evaluation of psychosocial problems of the homebound cancer patient: I. Methodology and problem frequencies. Source Psychosomatic Medicine. 45(1):11-21, 1983 Mar. MeSH Subject Headings Adaptation, Psychological Adult Affective Symptoms/px [Psychology] *Breast Neoplasms/px [Psychology] *Cervix Neoplasms/px [Psychology] Cognition Disorders/px [Psychology] Counseling Family Female Human *Lung Neoplasms/px [Psychology] Male Middle Age Pain, Intractable/px [Psychology] Patient Compliance Professional-Patient Relations Sick Role *Social Adjustment Support, U.S. Gov't, Non-P.H.S. *Terminal Care/px [Psychology] Abstract Psychological problem frequencies of very ill, homebound cancer patients were studied using an instrument entitled "Psychosocial Problem Categories for Homebound Cancer Patients." This instrument contains thirteen major categories of problems and fifty individual problems. A total of 570 patient records were obtained from two visiting nurse agencies in two different counties. Records were rated by a pair of trained raters, with level of interrater reliability being r = 0.96. Intervention frequencies by visiting health care professionals were also assessed. Percentages are based on at least one mention of problem or intervention. The five most frequent problem categories included: 1) Somatic side effects, 30% of total problems, of which pain involved 13% of total problems, 2) Patient mood disturbance, 15% of total problems, 3) Equipment problems, 8% of total problems, 4) Family relationship impairment, 7% of total problems, and 5) Cognitive impairment, 6% of total problems. The three most frequent interventions included: 1) Instructor/reinforcement to patient/family, 22% of total interventions, 2) No intervention for problem, 17% of total interventions, and 3) Counseling/emotional support, 17% of total interventions. Because the assessment instrument showed high interrater reliabilities for the two demographically dissimilar patient populations, it may be adaptable to heterogeneous populations. ISSN 0033-3174

<70> Unique Identifier 83082201 Authors Tasman A. Title Loss of self-cohesion in terminal illness. Source Journal of the American Academy of Psychoanalysis. 10(4):515-26, 1982 Oct. MeSH Subject Headings Adaptation, Psychological Attitude to Death Case Report Depression/px [Psychology] *Ego Human Lung Neoplasms/px [Psychology] Male Middle Age Psychoanalytic Therapy/mt [Methods] *Sick Role *Terminal Care/px [Psychology] ISSN 0090-3604

<71> Unique Identifier 83091769 Authors Weddington WW. Title Psychogenic nausea and vomiting associated with termination of cancer chemotherapy. Source Psychotherapy & Psychosomatics. 37(3):129-36, 1982. MeSH Subject Headings Adolescence Adult *Antineoplastic Agents/ae [Adverse Effects] Case Report Conditioning (Psychology) Female *Hodgkin Disease/dt [Drug Therapy] Hodgkin Disease/px [Psychology] Human *Lung Neoplasms/dt [Drug Therapy] Lung Neoplasms/px [Psychology] Male Nausea/ci [Chemically Induced] *Nausea/px [Psychology] Patient Compliance *Patient Dropouts/px [Psychology] *Psychophysiologic Disorders/px [Psychology] Referral and Consultation Sick Role Support, U.S. Gov't, P.H.S. Vomiting/ci [Chemically Induced] *Vomiting/px [Psychology] Abstract Psychogenic (pretreatment) nausea with or without vomiting develops in many patients undergoing chemotherapy for cancer. This phenomenon can be understood as classical aversive conditioning of the gastrointestinal system. Most patients tolerate this side effect of chemotherapy treatment. The author reports 4 patients who were non complaint or discontinued chemotherapy; each patient alleged that the pretreatment symptoms prompted this behavior. Closer examination revealed that these patients avoided chemotherapy because of multiple issues and used the pretreatment symptoms to explain their behavior. The cases illustrate the phenomenon of pretreatment nausea and methods of working therapeutically with oncologists and their patients. Registry Numbers 0 (Antineoplastic Agents). ISSN 0033-3190

<72> Unique Identifier 82013115 Authors Simonton OC. Matthews-Simonton S. Title Cancer and stress: counselling the cancer patient. Source Medical Journal of Australia. 1(13):679, 682-3, 1981 Jun 27. MeSH Subject Headings Breast Neoplasms/px [Psychology] *Counseling/mt [Methods] Female Human Lung Neoplasms/px [Psychology] Male Middle Age *Neoplasms/px [Psychology] Rectal Neoplasms/px [Psychology] *Stress, Psychological/et [Etiology] Stress, Psychological/th [Therapy] Time Factors Abstract In addition to the commonly accepted aetiological agents of cancer, such as chemical carcinogens, oncogenic viruses, hereditary factors, irradiation, and chronic trauma, multiple psychological factors are also important. Among these are psychological depression, impaired emotional outlets, and perceived lack of closeness to parents. The effect of addressing these factors in addition to standard medical factors in addition to standard medical management is an important question to be answered. A pilot study is in progress, in which patients with medically advanced malignant disease are being counselled in addition to receiving appropriate medical treatment. Standard mental health processes of counselling are employed in a combination of individual and group counselling sessions. From 1974 through 1978, a total of 193 patients with medically advanced malignant disease have received counselling in addition to their medical treatment. The three most frequent diagnoses are breast cancer (71), bowel cancer (28), and lung cancer (24). These are also the three most common diagnoses in the United States. In this study we have observed median survival times of 38.5 months in advanced breast cancer, 22.5 months in advanced bowel cancer, and 14.5 months in advanced lung cancer. These survival times are considerably longer than expected median survival times reported in the literature. Our primary concern in using this approach was that the counselling be helpful and not detrimental to the duration of life, quality of life, and quality of death of the individual. Preliminary results indicate that counselling can be helpful and can also be detrimental, depending upon the dynamics of the relationships among the counsellor, the patients, the medical team and the family. This is a preliminary study, and many major questions remain unanswered. ISSN 0025-729X

<73> Unique Identifier 81154062 Authors Anonymous. Title [This is how patients can feel...Something's wrong...]. [Dutch] Original Title Zo kunnen patienten zich voelen...Het is mis.... Source Tijdschrift voor Ziekenverpleging. 34(5):233-7, 1981 Mar 3. MeSH Subject Headings *Adaptation, Psychological Aged Case Report Human *Lung Neoplasms/px [Psychology] Lung Neoplasms/su [Surgery] Male Patient Advocacy ISSN 0303-6456

<74> Unique Identifier 81152389 Authors Clave M. Title [Those patients with lung cancer]. [French] Original Title Ces malades atteints d'un cancer du poumon. Source Revue de l Infirmiere. 31(3):22-6, 1981 Feb. MeSH Subject Headings Human *Lung Neoplasms/nu [Nursing] Lung Neoplasms/px [Psychology] Nurse-Patient Relations Professional-Family Relations Stress, Psychological Terminal Care ISSN 0397-7900

<75> Unique Identifier 81070311 Authors Gordon WA. Freidenbergs I. Diller L. Hibbard M. Wolf C. Levine L. Lipkins R. Ezrachi O. Lucido D. Title Efficacy of psychosocial intervention with cancer patients. Source Journal of Consulting & Clinical Psychology. 48(6):743-59, 1980 Dec. MeSH Subject Headings Adaptation, Psychological *Breast Neoplasms/px [Psychology] Female Human *Lung Neoplasms/px [Psychology] Male *Melanoma/px [Psychology] Middle Age *Social Adjustment Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S. ISSN 0022-006X

<76> Unique Identifier 80229440 Authors Murray JB. Title Psychosomatic aspects of cancer: an overview. [Review] [56 refs] Source Journal of Genetic Psychology. 136(2d Half):185-94, 1980 Jun. MeSH Subject Headings Adult Body Image Breast Neoplasms/px [Psychology] Cervix Neoplasms/px [Psychology] Denial (Psychology) Female Human Life Change Events Lung Neoplasms/px [Psychology] Male Middle Age Neoplasms/im [Immunology] *Neoplasms/px [Psychology] Personality *Psychophysiologic Disorders Repression Self Concept Stress, Psychological Abstract An overview of research on the psychosomatic aspects of cancer indicated that earlier psychoanalytic interpretations which focused on intrapsychic elements have given way to considerations of rehabilitation of victims of cancer and assistance with the complex emotional reactions of patients to terminal disease and of patients' families both to the disease and to death. [References: 56] ISSN 0022-1325

<77> Unique Identifier 80131712 Authors Khosla T. Campbell H. Title Mortality of male doctors and reductions in cigarette smoking [letter]. Source British Medical Journal. 280(6210):331, 1980 Feb 2. Local Messages CMC, 1981- MeSH Subject Headings Age Factors Aged Cerebrovascular Disorders/mo [Mortality] Coronary Disease/mo [Mortality] Human Lung Neoplasms/mo [Mortality] Male Middle Age *Physicians *Smoking/mo [Mortality] Smoking/pc [Prevention & Control] Stress, Psychological/mo [Mortality] ISSN 0007-1447

<78> Unique Identifier 80047809 Authors Weisman AD. Title A model for psychosocial phasing in cancer. Source General Hospital Psychiatry. 1(3):187-95, 1979 Sep. MeSH Subject Headings Adaptation, Psychological Attitude to Death Awareness Breast Neoplasms/px [Psychology] Colonic Neoplasms/px [Psychology] Female Hodgkin Disease/px [Psychology] Human Lung Neoplasms/px [Psychology] Male Melanoma/px [Psychology] Models, Psychological Neoplasm Recurrence, Local/px [Psychology] *Neoplasms/px [Psychology] Neoplasms/th [Therapy] *Social Adjustment Stress, Psychological/px [Psychology] Support, U.S. Gov't, P.H.S. Abstract The way in which patients cope with cancer throughout the course of treatment and illness can be demonstrated by correlating levels and types of vulnerability with different psychosocial phases. The concept of psychosocial phasing is a hypothesis, the aim of which is to integrate typical problems, concerns, and distress with clinical staging, treatment, and disease progression. Expectations differ at each phase. Accordingly, different problems may arise which clinicians can anticipate and relieve through appropriate interventions. ISSN 0163-8343

<79> Unique Identifier 79150242 Authors Goodwin JO. Title Programed instruction for self-care following pulmonary surgery. Source International Journal of Nursing Studies. 16(1):29-40, 1979. Local Messages CMC, 1987- MeSH Subject Headings Behavior Therapy/mt [Methods] Carcinoma, Bronchogenic/su [Surgery] Comparative Study Evaluation Studies Human Learning Lung Neoplasms/su [Surgery] Models, Psychological *Patient Education *Patients/ed [Education] *Pneumonectomy Postoperative Care *Programmed Instruction *Rehabilitation/ed [Education] Stress, Psychological/pc [Prevention & Control] *Teaching/mt [Methods] ISSN 0020-7489

<80> Unique Identifier 79093856 Authors Fiore N. Title Fighting cancer--one patient's perspective. Source New England Journal of Medicine. 300(6):284-9, 1979 Feb 8. Local Messages CMC, 1964- MeSH Subject Headings Adult *Attitude to Health Case Report Depression/et [Etiology] Depression/pc [Prevention & Control] Human Life Style Lung Neoplasms/dt [Drug Therapy] Male Neoplasm Metastasis *Neoplasms/px [Psychology] Neoplasms/th [Therapy] *Patient Acceptance of Health Care Patient Care Team Patient Compliance *Patient Education *Patient Participation *Patients/ed [Education] Physician-Patient Relations Psychotherapy Stress, Psychological/pc [Prevention & Control] Teratoma/dt [Drug Therapy] Teratoma/su [Surgery] Testicular Neoplasms/dt [Drug Therapy] Testicular Neoplasms/su [Surgery] ISSN 0028-4793

<81> Unique Identifier 80093740 Authors Dansak DA. Cordes RS. Title Cancer: denial or suppression?. Source International Journal of Psychiatry in Medicine. 9(3-4):257-62, 1978-79. MeSH Subject Headings *Adaptation, Psychological Adult Attitude to Death Case Report *Denial (Psychology) Female Human Liver Neoplasms/px [Psychology] Liver Neoplasms/sc [Secondary] Lung Neoplasms/px [Psychology] Male Mediastinal Neoplasms/px [Psychology] Middle Age *Neoplasms/px [Psychology] Abstract Medical personnel often reach erroneous judgments on the reaction of cancer patients to death and dying. Patients with terminal cancer sometimes will say little or nothing to hospital staff members or other professionals about their fears or expectations. This silence is generally construed as indicative of the primitive defense mechanism of denial. Usually, however, such patients are not truly "denying" cancer and its consequences, but have merely decided, more or less voluntarily, to "suppress" these thoughts as a method of coping with their illness. The medical staff, through careful observation of cancer patients, and through discussions with patients' families, should be able to distinguish between denial and suppression. This distinction can be significant because it enables the staff to understand the patient's feelings correctly, and thereby to provide more effective care. The staff, and the patients themselves, are thus in a better position to orchestrate the patients' various physical, emotional and interpersonal needs and resources optimally. ISSN 0091-2174

<82> Unique Identifier 79238588 Authors Bortner RW. Title Notes on expected life-history with introduction by Daniel J Levinson. Source International Journal of Aging & Human Development. 9(4):291-4, 1978-79. MeSH Subject Headings Adaptation, Psychological Human *Human Development Lung Neoplasms/px [Psychology] Personality ISSN 0091-4150

<83> Unique Identifier 78050945 Authors Cramer I. Blohmke M. Bahnson CB. Bahnson MB. Scherg H. Weinhold M. Title [Psychosocial factors and cancer. A study of 80 women by means of a psychosocial questionnaire (author's transl)]. [German] Original Title Psychosoziale Faktoren und Krebs. Untersuchung von 80 Frauen mit einem psychosozialen Fragebogen. Source MMW - Munchener Medizinische Wochenschrift. 119(43):1387-92, 1977 Oct 28. MeSH Subject Headings Adult Behavior Breast Neoplasms/px [Psychology] English Abstract Family Family Characteristics Female Human Lung Neoplasms/px [Psychology] Middle Age Neoplasms/et [Etiology] *Neoplasms/px [Psychology] Personality Psychophysiologic Disorders/co [Complications] Questionnaires Stomach Neoplasms/px [Psychology] Stress, Psychological Abstract The psychosocial questionnaire compiled by C. B. Bahnson and M. B. Bahnson and adapted for the German-speaking area was used to question 40 female cancer patients (30 mammary, 6 gastric and 4 pulmonary carcinomata) aged between 36 and 64 years and 40 control subjects selected by the matched pairs method. The cross section examination showed significant differences (p less than or equal to 0.05) between cancer patients and control subjects on single variate examination in 10 individual variables. Discriminant analysis (multivariate examination) revealed a discriminant function of 12 variables which enabled the classification of the entire collective of subjects with 95 percent accuracy in the carcinoma and control groups. Our results confirm largely the hypotheses developed in the USA. ISSN 0341-3098

<84> Unique Identifier 77243551 Authors Le Roy Ladurie M. Le Brigand H. Silbert D. Title [Quality of life after pneumonectomy for cancer]. [French] Original Title Qualite de la vie apres pneumonectomie pour cancer. Source Broncho-Pneumologie. 27(3):238-45, 1977 May-Jun. MeSH Subject Headings Adaptation, Psychological Disability Evaluation Dyspnea/et [Etiology] Female Follow-Up Studies Human *Lung Neoplasms/su [Surgery] Male Middle Age Occupations *Quality of Life Respiratory Insufficiency/et [Etiology] ISSN 0395-3904

<85> Unique Identifier 77184359 Authors McCorkle R. Title Terminal illness: human attachments and intended goals. Source Communicating Nursing Research. 9:207-21, 1977 Apr. MeSH Subject Headings *Adaptation, Psychological Adult Aged Communication Female Human *Interpersonal Relations Longitudinal Studies *Lung Neoplasms Male Middle Age Social Behavior Verbal Behavior ISSN 0160-1652

<86> Unique Identifier 77164865 Authors Booth G. Title A "spontaneous" recovery from cancer. Source Journal of the American Academy of Psychoanalysis. 5(2):207-14, 1977 Apr. MeSH Subject Headings Adaptation, Psychological Aggression Attitude to Health Authoritarianism Case Report Female Hostility Human *Lung Neoplasms/pa [Pathology] Marriage Middle Age Mother-Child Relations *Neoplasm Regression, Spontaneous Personality Psychosexual Development Sibling Relations ISSN 0090-3604

<87> Unique Identifier 76069848 Authors Levine J. Zigler E. Title Denial and self-image in stroke, lung cancer, and heart disease patients. Source Journal of Consulting & Clinical Psychology. 43(6):751-7, 1975 Dec. MeSH Subject Headings Adaptation, Psychological Adult Aged Attitude to Health *Cerebrovascular Disorders *Denial (Psychology) *Heart Diseases Human *Lung Neoplasms Male Middle Age *Self Concept Support, U.S. Gov't, Non-P.H.S. Support, U.S. Gov't, P.H.S. ISSN 0022-006X

<88> Unique Identifier 72240129 Authors Truhaut R. Dechambre RD. Title [Methods of induction in mice of pulmonary tumors with benzo-(a)-pyrene: influence of the dose of aromatic hydrocarbon and of ecological factors]. [French] Original Title Modalites de l'induction chez la souris de tumeurs pulmonaires par le benzo-(a)-pyrene: influence de la dose d'hydrocarbure aromatique et de facteurs ecologiques. Source Comptes Rendus Hebdomadaires des Seances de l Academie des Sciences - D: Sciences Naturelles. 274(15):2263-7, 1972 Apr 10. MeSH Subject Headings Adenoma/ci [Chemically Induced] Adrenal Glands Animal Benzopyrenes/ad [Administration & Dosage] *Benzopyrenes Female Germ-Free Life Human Hydrocarbons/pd [Pharmacology] Injections, Subcutaneous *Lung Neoplasms/ci [Chemically Induced] Mice *Neoplasms, Experimental/ci [Chemically Induced] Organ Weight Social Isolation *Stress, Psychological Time Factors ISSN 0567-655X

<89> Unique Identifier 72182835 Authors Barton D. Kelso MT. Title The nurse as a psychiatric consultation team member. Source Psychiatry in Medicine. 2(2):108-15, 1971 Apr. MeSH Subject Headings Adaptation, Psychological Adolescence Adult Dialysis Female Health Manpower/ed [Education] Hospitals, General Human Interprofessional Relations Lung Neoplasms Male *Mental Disorders/di [Diagnosis] Mental Disorders/th [Therapy] Middle Age Nurse-Patient Relations Nursing Care *Patient Care Team *Psychiatric Nursing *Referral and Consultation Research Scoliosis Stress, Psychological Terminal Care ISSN 0033-278X

<90> Unique Identifier 71137237 Authors Brown RI. Title Psychological factors and steroid abnormalities in lung cancer. Source Lancet. 1(7699):593, 1971 Mar 20. Local Messages CMC, 1975- MeSH Subject Headings Human *Lung Neoplasms/me [Metabolism] Lung Neoplasms/pp [Physiopathology] Psychological Tests *Stress, Psychological *17-Hydroxycorticosteroids/me [Metabolism] ISSN 0140-6736

<91> Unique Identifier 73224828 Authors Pettavel J. Title Limits of palliative surgery in cancer. Source Aktuelle Probleme in der Chirurgie. 14:709-24, 1970. MeSH Subject Headings Adrenalectomy Bone Neoplasms/su [Surgery] Brain Neoplasms/su [Surgery] Breast Neoplasms/th [Therapy] Castration Female Human Length of Stay Liver Neoplasms/su [Surgery] Lung Neoplasms/su [Surgery] Male Middle Age Neoplasm Metastasis Neoplasms/rt [Radiotherapy] *Neoplasms/su [Surgery] Ovary/su [Surgery] Palliative Care Prostatic Neoplasms/th [Therapy] Stress, Psychological Testis/su [Surgery] ISSN 0065-5589

<92> Unique Identifier 71287243 Authors Crisp AH. Title Some psychosomatic aspects of neoplasia. [Review] [134 refs] Source British Journal of Medical Psychology. 43(4):313-31, 1970 Dec. MeSH Subject Headings Adolescence Adult Animal Attitude to Health Breast Neoplasms/et [Etiology] Cell Division Cell Transformation, Neoplastic Cervix Neoplasms/et [Etiology] Child Child, Preschool Emotions Epidemiologic Methods Female Human Lung Neoplasms/et [Etiology] Male Mental Disorders/co [Complications] MMPI *Neoplasms/et [Etiology] Neoplasms, Experimental/et [Etiology] Neurotic Disorders/co [Complications] Personality Prognosis Psychological Tests Psychological Theory *Psychophysiologic Disorders Psychophysiology Psychosomatic Medicine Rabbits Rats Remission, Spontaneous Research Schizophrenia/co [Complications] Specialties, Medical Stress, Psychological ISSN 0007-1129

<93> Unique Identifier 71032227 Authors Johns MW. Title Steroid abnormalities in lung cancer. Source Lancet. 2(7683):1139, 1970 Nov 28. Local Messages CMC, 1975- MeSH Subject Headings Adrenal Cortex Hormones/se [Secretion] Circadian Rhythm Human *Lung Neoplasms/me [Metabolism] Male Sex Factors Sleep Stress, Psychological/me [Metabolism] Urine/an [Analysis] *17-Hydroxycorticosteroids/ur [Urine] ISSN 0140-6736

<94> Unique Identifier 70269938 Authors Rao LG. Title Discriminant function based on steroid abnormalities in patients with lung cancer. Source Lancet. 2(7670):441-5, 1970 Aug 29. Local Messages CMC, 1975- MeSH Subject Headings Adult Aged Androsterone/me [Metabolism] *Androsterone/ur [Urine] Etiocholanolone/me [Metabolism] *Etiocholanolone/ur [Urine] Human *Lung Neoplasms/pp [Physiopathology] Lung Neoplasms/su [Surgery] Male Middle Age Pituitary-Adrenal System Prasterone/me [Metabolism] *Prasterone/ur [Urine] Stress Stress, Psychological Testis/pp [Physiopathology] 17-Hydroxycorticosteroids/me [Metabolism] *17-Hydroxycorticosteroids/ur [Urine] ISSN 0140-6736

<95> Unique Identifier 70035349 Authors Kissen DM. Brown RI. Kissen M. Title A further report on personality and psychosocial factors in lung cancer. Source Annals of the New York Academy of Sciences. 164(2):535-45, 1969 Oct 14. MeSH Subject Headings Human *Lung Neoplasms/et [Etiology] *Personality *Personality Inventory *Psychophysiologic Disorders Smoking ISSN 0077-8923

<96> Unique Identifier 70035342 Authors Kissen DM. Rao LG. Title Steroid excretion patterns and personality in lung cancer. Source Annals of the New York Academy of Sciences. 164(2):476-82, 1969 Oct 14. MeSH Subject Headings *Adrenal Glands/ph [Physiology] Aged Hospitalization Human *Lung Neoplasms/ur [Urine] Male Middle Age *Personality *Stress, Psychological *17-Hydroxycorticosteroids/ur [Urine] *17-Ketosteroids/ur [Urine] ISSN 0077-8923