8 research outputs found
Distress Reduction From a Psychological Intervention Contributes to Improved Health for Cancer Patients
Purpose. Psychological interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether psychological improvements are, in turn, related to improved health. A clinical trial tests whether a psychological intervention for cancer patients can do so, and also tests two routes to achieve better health: (a) reducing patients\u27 Emotional Distress, and/or (b) enhancing their functional immunity. Methods. Post-surgery, 227 breast cancer patients were randomized to intervention or assessment only Study Arms. Conducted in small groups, intervention sessions were offered weekly for 4 months and followed by monthly sessions for 8 months. Measures included psychological (distress), biological (immune), and health outcomes (performance status and evaluations of patient\u27s symptomatology, including toxicity from cancer treatment, lab values) collected at baseline, 4 months, and 12 months. Results. A path model revealed that intervention participation directly improved health (p \u3c .05) at 12 months. These effects remained when statistically controlling for baseline levels of distress, immunity, and health as well as sociodemographic, disease, and cancer treatment variables. Regarding the mechanisms for achieving better health, support was found for an indirect effect of distress reduction. That is, by specifically lowering intervention patients\u27 distress at 4 months, their health was improved at 12 months (p \u3c .05). Although the intervention simultaneously improved patients\u27 T-cell blastogenesis in response to phytohemagglutinin (PHA), the latter increases were unrelated to improved health. Conclusion. A convergence of biobehavioral effects and health improvements were observed. Behavioral change, rather than immunity change, was influential in achieving lower levels of symptomatology and higher functional status. Distress reduction is highlighted as an important mechanism by which health can be improved
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Screening and Identification of Depression Among Patients with Coronary Heart Disease and Congestive Heart Failure
Depression occurring concurrently with cardiovascular diseases is associated with poor outcomes. Several review articles have examined the link between established indices of depression and prognosis in individuals with known coronary heart disease (CHD). These studies have demonstrated relatively consistent results and suggest an important connection between cardiovascular morbidity and mortality in patients with depressive symptoms or major depression. This article discusses the current best practices for the screening, identification, and treatment of depression in patients with CHD and coronary heart failure, as well as the financial aspects associated with care management