Education and peer discussion group interventions and adjustment to breast cancer.

BACKGROUND: We report a clinical trial comparing the effectiveness of education-based and peer discussion-based group interventions on adjustment to breast cancer. METHODS: Women with stage I, II, or III breast cancer (n = 312) were randomly assigned to 1 of 4 group conditions: control, education, peer discussion, or education plus peer discussion (combination). Seven groups (each comprising 8-12 women) were conducted in each of the 4 conditions (28 groups total). Adjustment was measured before the intervention, immediately after the intervention, and 6 months after the intervention. RESULTS: Consistently positive effects on adjustment were seen in the education groups both immediately following and 6 months after the intervention. There were no benefits of participation in peer discussion groups, and some indications of adverse effects on adjustment at both follow-up examinations. The effects could be explained by changes in self-esteem, body image, and intrusive thoughts about the illness. CONCLUSIONS: Education-based group interventions facilitated the initial adjustment of women diagnosed with early stage breast cancer. There was no evidence of benefits from peer discussion group interventions.</p

Self-regulation of common age-related challenges: benefits for older adults' psychological and physical health.

This article addresses the role played by adaptive self-regulation in protecting older adults' psychological and physical health. A theoretical model is outlined illustrating how common age-related challenges (i.e., physical challenges and life regrets) can influence older adults' health. In addition, the proposed model suggests that older adults can avoid the adverse health effects of encountering these problems if they engage in adaptive self-regulation. Finally, this article reviews recent studies that examined the adaptive value of self-regulation processes for managing physical challenges and life regrets in the elderly. The findings from cross-sectional, longitudinal, and experimental studies document the importance of adaptive self-regulation for maintaining older adults' health.</p

Long-term effects of educational and peer discussion group interventions on adjustment to breast cancer.

The authors report a 3-year follow-up of the effects of 8-week support group interventions on the quality of life of women with early stage breast cancer. Shortly after diagnosis, women were randomly assigned to 1 of 4 conditions: control, education, peer discussion, and education plus peer discussion. The education group intervention focused on providing information to enhance control over the illness experience, whereas the peer discussion group intervention focused on providing emotional support through the expression of feelings. Consistent with the results that emerged 6 months after the interventions (V. S. Helgeson, S. Cohen, R. Schulz & J. Yasko, 1999), the authors found that the benefits of the education intervention were maintained over a 3-year period N = 252) although effects dissipated with time. The authors continued to find no benefits of the peer discussion intervention, either alone or in combination with educatio

The Importance of Goal Disengagement in Adaptive Self-Regulation: When Giving Up is Beneficial

This paper develops the argument that goal disengagement forms an essential aspect of effective self-regulation. The argument derives from a consideration of processes inherent in the life-span development of the individual, as well as processes inherent in the moment-to-moment regulation of action. Evidence is reviewed to support the idea that goal disengagement can be beneficial to psychological well-being. In addition, the article addresses the nature of disengagement. It is argued that disengagement requires a person to withdraw not only effort but also commitment from unattainable goals, and is most adaptive if it leads to pursuing new meaningful goals. The paper also discusses the manner in which various aspects of the self might support or hinder the disengagement process. The paper closes by addressing the break point between goal engagement and disengagement and suggesting several directions for future research.</p

Group Support Interventions for Women With Breast Cancer: Who Benefits From What?

Research on the benefits of social support groups has beenA inconclusive. One reason is that individual differences in intervention responses have rarely been examined. The authors determined the extent to which individual difference variables moderated the effects of an information-based educational group and an emotion-focused peer discussion group on the mental and physical functioning of women with breast cancer (n = 230). The authors administered the SF-36 (S. E. Ware, K. K. Snow, M. Kosinski, & B. Gandek, 1993), a multidimensional quality of life instrument, pre- and postintervention. Educational groups showed greater benefits on the physical functioning of women who started the study with more difficulties compared with less difficulties (e.g., lacked support or fewer personal resources). Peer discussion groups were helpful for women who lacked support from their partners or physicians but harmful for women who had high levels of support. Implications of these results for clinical interventions are discussed

Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions.

Men who were recently treated for prostate cancer (N=250) were randomly assigned to a control group, a group education intervention (GE), or a group education-plus-discussion intervention (GED). Both GE and GED increased prostate cancer knowledge. In the year postintervention, men in the GED condition were less bothered by sexual problems than men in the control condition, and they were more likely to remain steadily employed (93.0%) than men in the GE (75.6%) or control (72.5%) conditions. Among noncollege graduates, GED and GE resulted in better physical functioning than the control condition, and GED resulted in more positive health behaviors than the control or GE condition. Among college graduates, controls were comparable with the GE and GED groups in physical functioning and positive health behaviors.</p

Does who you marry matter for your health? Influence of patients' and spouses' personality on their partners' psychological well-being following coronary artery bypass surgery.

Research suggests that presurgical personality attributes influence postsurgical well-being in both patients and their spouses in the context of coronary artery bypass grafting (CABG) surgery. The authors hypothesized that a spouse's characteristics would influence a partner's psychological well-being, regardless of whether he or she was the patient or the caregiver. In this study, 111 male patients and their caregiver spouses completed measures of neuroticism, optimism, perceived marital satisfaction, and depression prior to elective CABG. Follow-up was conducted at 18 months. As expected, higher caregiver presurgical neuroticism predicted higher patient depressive symptoms at follow-up, with caregiver's concurrent 18-month affect controlled for. Likewise, higher patient presurgical neuroticism predicted higher caregiver depressive symptoms at follow-up. Additionally, higher patient presurgical depressive symptoms and lower presurgical optimism contributed to greater caregiving burden. Relationship satisfaction moderated these effects. These results suggest that partners' personality traits are important determinants of both patients' and their caregiving spouses' well-being.</p

Positive and negative religious coping and well-being in women with breast cancer.

BACKGROUND: Although religions is important to many people with cancer, few studies have explored the relationship between religious coping and well-being in a prospective manner, using validated measures, while controlling for important covariates. METHODS: One hundred ninety-eight women with stage I or II and 86 women with stage IV stage breast cancer were recruited. Standardized assessment instruments and structured questions were used to collect data at study entry and 8 to 12 months later. Religious coping was measured with validated measures of positive and negative religious coping. Linear regression models were used to explore the relationships between positive and negative religious coping and overall physical and mental well-being, depression, and life satisfaction. RESULTS: The percentage of women who used positive religious coping (i.e., partnering with God or looking to God for strength, support, or guidance) "a moderate amount" or "a lot" was 76%. Negative religious coping (i.e., feeling abandoned by or anger at God) was much less prevalent; 15% of women reported feeling abandoned by or angry at God at least "a little." Positive religious coping was not associated with any measures of well-being. Negative religious coping predicted worse overall mental health, depressive symptoms, and lower life satisfaction after controlling for sociodemographics and other covariates. In addition, changes in negative religious coping from study entry to follow-up predicted changes in these well-being measures over the same time period. Cancer stage did not moderate the relationships between religious coping and well-being. CONCLUSIONS: Negative religious coping methods predict worse mental heath and life satisfaction in women with breast cancer.</p

Adaptive self-regulation of unattainable goals: goal disengagement, goal reengagement, and subjective well-being.

Three studies examined associations between goal disengagement, goal reengagement, and subjective well-being. In Study 1, 115 undergraduates reported on the extent to which they were able to abandon unattainable goals and reengage their efforts in alternative goals. Study 2 examined the importance of goal disengagement and goal reengagement in groups of young adults and older adults (N = 120). In Study 3, a sample of parents of children with cancer and parents of medically healthy children was examined (N = 45). The findings confirmed that goal disengagement and goal reengagement can be associated with ratings of high subjective well-being. In addition, the results showed that goal disengagement and goal reengagement can have interactive effects on subjective well-being. The importance of the findings for effective self-regulation and successful development are discussed.</p

Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness.

Links between chronic illness and family relationships have led to psychosocial interventions targeted at the patient's closest family member or both patient and family member. The authors conducted a meta-analytic review of randomized studies comparing these interventions with usual medical care (k=70), focusing on patient outcomes (depression, anxiety, relationship satisfaction, disability, and mortality) and family member outcomes (depression, anxiety, relationship satisfaction, and caregiving burden). Among patients, interventions had positive effects on depression when the spouse was included and, in some cases, on mortality. Among family members, positive effects were found for caregiving burden, depression, and anxiety; these effects were strongest for nondementing illnesses and for interventions that targeted only the family member and that addressed relationship issues. Although statistically significant aggregate effects were found, they were generally small in magnitude. These findings provide guidance in developing future interventions in this area.</p