Parents of Children with Cancer: A Longitudinal Study of Emotional Distress, Coping Style, and Marital Adjustment Two and Twenty Months After Diagnosis

Evaluated emotional distress, coping style, and marital adjustmentin 84 parents (42 couples) of children with cancer 2 monthsafter diagnosis and again about 20 months after diagnosis. Asexpected, mothers' mean state anxiety and trait anxiety scoresdecreased to near normal levels over time. Fathers' scores werelower initially and did not change. Neither mothers' nor fathers'mean marital adjustment scores changed over time. Marital adjustmentat treatment follow-up was predicted by depression and the spouse'smarital satisfaction in mothers, and depression, child healthstatus, and spouse's marital satisfaction in fathers. In contrastto findings obtained 2 months after diagnosis, coping stylewas not related to marital adjustment at follow-up. Resultsare discussed in terms of possible gender differences in therole of social support in marital adjustment and the stabilityversus situational specificity of coping styles.     

Supportive and Negative Responses in the Partner Relationship: Their Association with Psychological Adjustment Among Individuals with Cancer

This study examined the association between positive and negative aspects of spouse responses and psychological adjustment among 15S individuals with cancer. Two contextual variables, gender and disease-related functional impairment, were taken into account when examining the association between spouse responses and patient psychological distress and well-being. Results indicated that negative aspects of close relationships played a comparatively stronger role than positive aspects in their associations with both psychological distress and well-being. For negative spouse responses, patient gender did not moderate the effects of these responses upon psychological outcomes. For positive aspects of spouse support, both gender and functional disability moderated the association between spouse support and psychological outcomes. These findings are integrated with the general literature on positive and negative aspects of close relationships. Implications for clinical interventions are also discussed.     

Benefits of training at moderate altitude versus sea level training in amateur runners

After more than 25 years of research on altitude training (AT) there is no consensus regarding either the training programme at altitude or the effects of AT on performance at sea level. Based on a review of the research work on AT, we investigated combined base training and interval training at moderate altitude and compared immediate and delayed effects on sea level performance with those following similar sea level training (SLT). The altitude group (AG, 10 male amateur runners) trained at 2315 m (natural altitude) and the sea level group (SLG, 12 male amateur runners) at 187 m. Both groups performed 7 days of base training (running on a trail) lasting between 60 and 90 min a day and 5 days of interval training (speed and hill runs) for between 10 and 45 min a day. Incremental exercise tests were performed 1 week before (t ₁), 3 days after (t ₂) and 16 days after (t ₃) the 12-day main training period. Within AG, exercise performance improved fromt ₁ tot ₂ by 8% (P<0.05) and fromt ₂ tot ₃ by 8% (P<0.05). Maximum oxygen uptake ( ) increased fromt ₂ tot ₃ by 10% (P<0.05). Within SLG exercise performance increased fromt ₂ tot ₃ by 8% (P<0.05). Att ₃, relative and absolute in AG were significantly higher in comparison with SLG (P=0.005 andP=0.046 respectively). The improved performance 3 days after AT may be explained in part by an increased oxygen uptake at submaximal exercise intensities without a change in . Further enhancement in performance 2 weeks after AT, however, seems to have been due to the clearly enhanced . Progressive cardiovascular adjustments might have contributed primarily to the time-dependent improvements observed after AT, possibly by an enhanced stroke volume overcompensating the reduced heart rates during submaximal exercise. In conclusion, our findings would suggest that training at a moderate natural altitude improves performance at sea level more than SLT. Combining base and interval training with regulation of intensity by training at constant heart rates during acclimatization at altitude would seem to be a successful training regimen for amateur runners. Most beneficial effects became apparent during the subsequent SLT around 2 weeks after return from altitude. Therefore, we are convinced that AT should be reconsidered as a potent tool for enhancing aerobic capacity, at least in non-elite athletes.     

Residents' perspectives of their first 2 weeks in a long-term care facility

• ? This study investigated residents' perspectives of their first 2 weeks in a long-term care facility (LTCF). Twelve residents were interviewed to determine their experiences during the first 2 weeks, their needs, priorities and expectations, and their views about how relocation from home could be facilitated. The constant comparative method of qualitative analysis (Glaser & Strauss, 1967) was used.
• ? Qualitative analysis of the audiotaped interviews revealed four main categories: emotional reactions, transition activities, reflecting on their situation, and connecting with a personal philosophy.
• ? Residents' responses indicated that if they had actively participated in the decision to be admitted, the adjustment to the LTCF was easier. Connecting with a personal philosophy was also a significant factor.
• ? Nursing implications include recognition of the importance of preparing residents for admission, involving them in the decision, and listening to their perspectives throughout the relocation experience.

     

Behavioural and School Adjustment of 12–13-year old Internationally Adopted Children in Norway: a Research Note

Rutter's scales for parents and teachers were used to assess the behavioural and emotional adjustment of 151 12-13-year old internationally adopted children. Additional questions about school adjustment were added to the teachers' questionnaire. The majority of the adopted children were found to be well adjusted. However, the adopted children were given higher mean scores both for the full scale and on a "hyperactive" subscale than a comparison group of non-adopted children. More adopted than non-adopted children had problems with arithmetic. Adopted boys had higher mean scores than adopted girls on both Rutter scales. Age at adoption was unrelated to outcome.     

Psychological responses of patients receiving a diagnosis of cancer.

BACKGROUND: Current recommendations on how to break bad news are primarily based on expert opinion. Little is known about the association between communication practices and patients' psychological response. PATIENTS AND METHODS: One-hundred and thirty-one patients with newly diagnosed melanoma were surveyed 4 months after the initial consultation at the Sydney Melanoma Unit regarding their communication experiences and their satisfaction with these experiences. They completed the Hospital Anxiety and Depression Scale (HADS) at this time, and 4 and 13 months later. RESULTS: Both patients' satisfaction with communication and their psychological morbidity were found to be associated with particular communication practices. Practices linked to lower anxiety included preparing the patient for a possible diagnosis of cancer; having the people wanted by the patient present to hear the diagnosis; giving the patient as much information about the diagnosis as desired; providing written information; presenting the information clearly; discussing the patient's questions the same day; talking about the patient's feelings; and being reassuring. Practices linked with lower levels of depression included using the word 'cancer'; discussing the severity of the situation, life expectancy and how the cancer might affect other aspects of life; and encouraging the patient to be involved in treatment decisions. CONCLUSIONS: This study provided preliminary evidence that communication strategies recommended in the literature produce positive patient outcomes. Further studies are needed which document actual communication.     

Effects of Pediatric Chronic Physical Disorders on Child and Family Adjustment

Research conducted primarily over the past 5–8 years on the psychosocial effects of pediatric chronic physical disorders on children and their families is reviewed. A large body of studies show that both children and their mothers, as groups, are at increased risk for psychosocial adjustment problems compared to peers, but that there is considerable individual variation in outcome. Since the last review on this topic (Eiser, 1990a), many studies have been conducted to identify risk and resistance factors associated with differences in adjustment among these children and their mothers. Improvements are noted in the theoretical basis for this work, programmatic nature of some of the research, and efforts at producing clinically relevant information. Evaluations of interventions, however, are lagging. Critical issues and future directions regarding developmental approaches, theory, method, measurement and intervention are discussed.     

新时期医院制剂发展的思考

本文探讨新时期医院制剂的发展趋势.通过对"医院制剂存在的必要性"及"医院制剂特点"的分析,对"新时期医院制剂"的发展提出了几点建议,供医院药学工作者借鉴.     

论新编配体制下军队中小医院的建设与发展

分析和总结了军队中小医院在现行人员编配体制下,医院在管理、经营和发展中面临的主要问题和困难;结合工作实践,从正确认识新编制、积极适应新编制、认真落实新编制三个方面论述了解决问题的办法。     

SPECT探头系统的校正与调试

本文阐明了对SPECT探头校正与调试的重要性,特别是对探头校正与调试的具体方法与步骤作了详细介绍。