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Porter, Laura Streamo

Overview:

My research focuses on developing and evaluating behavioral interventions to help patients and their family members cope with the symptoms and psychological demands associated with chronic and life-limiting illness.

Positions:

Associate Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Associate Proessor in the School of Nursing

School of Nursing
School of Nursing

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1996

Ph.D. — State University of New York at Potsdam

Grants:

Translational Research in Surgical Oncology

Administered By
Surgery, Surgical Sciences
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
January 01, 2002
End Date
August 31, 2021

Caregiver-Guided Pain Management Training in Palliative Care

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 26, 2014
End Date
June 30, 2018

Couple Communication in Cancer: A Multi-method Examination

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
Arizona State University
Role
Principal Investigator
Start Date
September 20, 2016
End Date
August 31, 2017

Mobile Mindfulness to Improve Psychological Distress after Critical Illness

Administered By
Medicine, Pulmonary, Allergy, and Critical Care Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 01, 2015
End Date
June 30, 2017

Yoga-based Symptom Management for Metastatic Breast Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 2013
End Date
May 31, 2017

Mechanisms of Psychosocial Chronic Pain Treatment

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
Rush University
Role
Clinical Associate
Start Date
September 25, 2013
End Date
December 31, 2016

Communication in Oncologist Patient Encounters: A Patient Intervention

Administered By
Duke Cancer Institute
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
June 01, 2009
End Date
April 30, 2016

Feasibility of a Couple-based Intervention for Parents of Children with Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
July 09, 2012
End Date
December 31, 2014

Coping Skills Training for Spinal Cord Stimulator Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 30, 2008
End Date
August 31, 2013

Stress and Behavior in Health and Disease

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Mentor
Start Date
July 01, 1989
End Date
June 30, 2011

Caregiver-Assisting Coping Skills Training for Lung Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Project Director
Start Date
June 06, 2002
End Date
May 31, 2008

Partner-Assisted Emotional Disclosure for GI Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
March 02, 2004
End Date
February 28, 2008

Prostate Cancer Recovery Enhancement (PROCARE) for African American Men

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 27, 2007
End Date
January 31, 2008
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Publications:

Patient-provider communication about sexual concerns in cancer: a systematic review.

Cancer survivors' needs around sexual concerns are often unmet. The primary objective of this systematic review was to examine the prevalence of and factors associated with patient-provider communication about sexual concerns in cancer.Using PRISMA guidelines, we searched PubMed/MEDLINE, PsychInfo, and CINAHL databases for peer-reviewed quantitative research papers (2000-2015) in cancer samples. Search terms across three linked categories were used (sexuality, communication, and cancer). The National Comprehensive Cancer Network (NCCN) Sexual Function Guidelines were used as a framework to categorize communication reported in each study.Twenty-nine studies from 10 countries (29 % in USA) were included. Studies assessed patients only (21), providers only (4), and both (4). Communication measures differed across studies and many lacked validity data. When reported by patients or providers, the average prevalence of discussing potential treatment effects on sexual function was 50 (60 % for men and 28 % for women) and 88 %, respectively. As reported by patients or providers, respectively, assessing patients' sexual concerns (10 and 21 %) and offering treatments (22 and 17 %) were measured in fewer studies and were reported less frequently. Both patients and providers (28 and 32 %, respectively) reported a low prevalence of other non-specific communication. Greater prevalence of communication was associated with male patient gender and more years of provider experience.Sexual issues go unaddressed for many cancer survivors, particularly women. Both patient and provider interventions are needed.Enhancing patient-provider communication about sexual concerns through evidence-based interventions could improve patient sexual function and quality of life.

Authors
Reese, JB; Sorice, K; Beach, MC; Porter, LS; Tulsky, JA; Daly, MB; Lepore, SJ
MLA Citation
Reese, JB, Sorice, K, Beach, MC, Porter, LS, Tulsky, JA, Daly, MB, and Lepore, SJ. "Patient-provider communication about sexual concerns in cancer: a systematic review." Journal of cancer survivorship : research and practice 11.2 (April 2017): 175-188.
PMID
27858322
Source
epmc
Published In
Journal of Cancer Survivorship
Volume
11
Issue
2
Publish Date
2017
Start Page
175
End Page
188
DOI
10.1007/s11764-016-0577-9

Mindful Yoga for women with metastatic breast cancer: design of a randomized controlled trial.

Women with metastatic breast cancer (MBC) have average life expectancies of about 2 years, and report high levels of disease-related symptoms including pain, fatigue, sleep disturbance, psychological distress, and functional impairment. There is growing recognition of the limitations of medical approaches to managing such symptoms. Yoga is a mind-body discipline that has demonstrated a positive impact on psychological and functional health in early stage breast cancer patients and survivors, but has not been rigorously studied in advanced cancer samples.This randomized controlled trial examines the feasibility and initial efficacy of a Mindful Yoga program, compared with a social support condition that controls for attention, on measures of disease-related symptoms such as pain and fatigue. The study will be completed by December 2017. Sixty-five women with MBC age ≥ 18 are being identified and randomized with a 2:1 allocation to Mindful Yoga or a support group control intervention. The 120-min intervention sessions take place weekly for 8 weeks. The study is conducted at an urban tertiary care academic medical center located in Durham, North Carolina. The primary feasibility outcome is attendance at intervention sessions. Efficacy outcomes include pain, fatigue, sleep quality, psychological distress, mindfulness and functional capacity at post-intervention, 3-month follow-up, and 6-month follow-up.In this article, we present the challenges of designing a randomized controlled trial with long-term follow-up among women with MBC. These challenges include ensuring adequate recruitment including of minorities, limiting and controlling for selection bias, tailoring of the yoga intervention to address special needs, and maximizing adherence and retention. This project will provide important information regarding yoga as an intervention for women with advanced cancer, including preliminary data on the psychological and functional effects of yoga for MBC patients. This investigation will also establish rigorous methods for future research into yoga as an intervention for this population.ClinicalTrials.gov identifer: NCT01927081 , registered August 16, 2013.

Authors
Carson, JW; Carson, KM; Olsen, MK; Sanders, L; Porter, LS
MLA Citation
Carson, JW, Carson, KM, Olsen, MK, Sanders, L, and Porter, LS. "Mindful Yoga for women with metastatic breast cancer: design of a randomized controlled trial." BMC complementary and alternative medicine 17.1 (March 13, 2017): 153-.
PMID
28288595
Source
epmc
Published In
BMC Complementary and Alternative Medicine
Volume
17
Issue
1
Publish Date
2017
Start Page
153
DOI
10.1186/s12906-017-1672-9

Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant.

We tested an uncertainty self-management telephone intervention (SMI) with patients awaiting liver transplant and their caregivers.Participants were recruited from four transplant centers and completed questionnaires at baseline, 10, and 12 weeks from baseline (generally two and four weeks after intervention delivery, respectively). Dyads were randomized to either SMI (n=56) or liver disease education (LDE; n=59), both of which involved six weekly telephone sessions. SMI participants were taught coping skills and uncertainty management strategies while LDE participants learned about liver function and how to stay healthy. Outcomes included illness uncertainty, uncertainty management, depression, anxiety, self-efficacy, and quality of life. General linear models were used to test for group differences.No differences were found between the SMI and LDE groups for study outcomes.This trial offers insight regarding design for future interventions that may allow greater flexibility in length of delivery beyond our study's 12-week timeframe.Our study was designed for the time constraints of today's clinical practice setting. This trial is a beginning point to address the unmet needs of these patients and their caregivers as they wait for transplants that could save their lives.

Authors
Bailey, DE; Hendrix, CC; Steinhauser, KE; Stechuchak, KM; Porter, LS; Hudson, J; Olsen, MK; Muir, A; Lowman, S; DiMartini, A; Salonen, LW; Tulsky, JA
MLA Citation
Bailey, DE, Hendrix, CC, Steinhauser, KE, Stechuchak, KM, Porter, LS, Hudson, J, Olsen, MK, Muir, A, Lowman, S, DiMartini, A, Salonen, LW, and Tulsky, JA. "Randomized trial of an uncertainty self-management telephone intervention for patients awaiting liver transplant." Patient education and counseling 100.3 (March 2017): 509-517.
PMID
28277289
Source
epmc
Published In
Patient Education and Counseling
Volume
100
Issue
3
Publish Date
2017
Start Page
509
End Page
517
DOI
10.1016/j.pec.2016.10.017

Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects.

Poor sleep quality among people with chronic low back pain appears to be related to worse pain, affect, poor physical function, and pain catastrophizing. The causal direction between poor sleep and pain remains an open question, however, as does whether sleep quality exerts effects on low back pain differently across the course of the day.This daily diary study examined lagged temporal associations between prior night sleep quality and subsequent day pain, affect, physical function and pain catastrophizing, the reverse lagged temporal associations between prior day pain-related factors and subsequent night sleep quality, and whether the time of day during which an assessment was made moderated these temporal associations.Chronic low back pain patients (n = 105) completed structured electronic diary assessments five times per day for 14 days. Items included patient ratings of their pain, affect, physical function, and pain catastrophizing.Collapsed across all observations, poorer sleep quality was significantly related to higher pain ratings, higher negative affect, lower positive affect, poorer physical function, and higher pain catastrophizing. Lagged analyses averaged across the day revealed that poorer prior night sleep quality significantly predicted greater next day patient ratings of pain, and poorer physical function and higher pain catastrophizing. Prior poorer night sleep quality significantly predicted greater reports of pain, and poorer physical function, and higher pain catastrophizing, especially during the early part of the day. Sleep quality × time of day interactions showed that poor sleepers reported high pain, and negative mood and low function uniformly across the day, whereas good sleepers reported relatively good mornings, but showed pain, affect and function levels comparable to poor sleepers by the end of the day. Analyses of the reverse causal pathway were mostly nonsignificant.Sleep quality appears related not only to pain intensity but also to a wide range of patient mood and function factors. A good night's sleep also appears to offer only temporary respite, suggesting that comprehensive interventions for chronic low back pain not only should include attention to sleep problems but also focus on problems with pain appraisals and coping.

Authors
Gerhart, JI; Burns, JW; Post, KM; Smith, DA; Porter, LS; Burgess, HJ; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Gerhart, JI, Burns, JW, Post, KM, Smith, DA, Porter, LS, Burgess, HJ, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects." Annals of behavioral medicine : a publication of the Society of Behavioral Medicine (November 14, 2016).
PMID
27844327
Source
epmc
Published In
Annals of Behavioral Medicine
Publish Date
2016

Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study.

Sexual concerns continue to be poorly addressed for women treated for breast cancer and evidence-based interventions that adequately address these concerns are scarce. The objective of this study was to adapt a telephone-based intimacy enhancement intervention, previously tested in couples facing colorectal cancer, to the needs of women with breast cancer through qualitative focus groups, cognitive interviews, and expert review.Three semistructured qualitative focus groups in partnered posttreatment breast cancer survivors (n = 15) reporting sexual concerns were conducted to investigate experiences of breast cancer-related sexual concerns and intervention preferences. Focus group data were coded using the framework approach to qualitative analysis; 8 key themes were identified and used to develop the content and format of the intervention. Feedback from cognitive interviews with study-naïve breast cancer survivors (n = 4) and expert review of materials were also incorporated in finalizing the intervention materials.Qualitative findings centered on the impact of breast cancer and its treatment on women's sexuality and on the intimate relationship, experiences of helpful and unhelpful coping methods, and explicit intervention preferences. Focus group data were particularly helpful in identifying the scope of educational topics and in determining how to structure intervention skills practice (e.g., intimacy-related communication) to be optimally relevant and helpful for both women and their partners. Cognitive interview feedback helped refine intervention materials.An intimacy enhancement intervention was adapted for women with breast cancer and their partners. This intervention offers a promising, potentially disseminable approach to addressing breast cancer-related sexual concerns. (PsycINFO Database Record

Authors
Reese, JB; Porter, LS; Casale, KE; Bantug, ET; Bober, SL; Schwartz, SC; Smith, KC
MLA Citation
Reese, JB, Porter, LS, Casale, KE, Bantug, ET, Bober, SL, Schwartz, SC, and Smith, KC. "Adapting a couple-based intimacy enhancement intervention to breast cancer: A developmental study." Health psychology : official journal of the Division of Health Psychology, American Psychological Association 35.10 (October 2016): 1085-1096.
PMID
27657981
Source
epmc
Published In
Health Psychology
Volume
35
Issue
10
Publish Date
2016
Start Page
1085
End Page
1096
DOI
10.1037/hea0000413

Anger arousal and behavioral anger regulation in everyday life among people with chronic low back pain: Relationships with spouse responses and negative affect.

To determine the degree to which anger arousal and anger regulation (expression, inhibition) in the daily lives of people with chronic pain were related to spouse support, criticism, and hostility as perceived by patients and as reported by spouses.Married couples (N = 105, 1 spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. On these diaries, patients completed items on their own anger arousal, anger expression, and inhibition, and on perceived spouse support, criticism, and hostility. Spouses reported on their responses toward patients and their negative affect. Hierarchical linear modeling tested concurrent and lagged relationships.Patient-reported increases in anger arousal and anger expression were predominantly related to concurrent decreases in patient-perceived and spouse-reported spouse support, concurrent increases in patient-perceived and spouse-reported spouse criticism and hostility, and increases in spouse-reported negative affect. Relationships for anger expression remained significant with anger arousal controlled. These effects were especially strong for male patients. Spouses reported greater negative affect when patients were present than when they were not.Social support may facilitate adjustment to chronic pain, with declining support and overt criticism and hostility possibly adversely impacting pain and function. Results suggest that patient anger arousal and expression may be related to a negative interpersonal environment for married couples coping with chronic low back pain.

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Post, KM; Smith, DA; Porter, LS; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Post, KM, Smith, DA, Porter, LS, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger arousal and behavioral anger regulation in everyday life among people with chronic low back pain: Relationships with spouse responses and negative affect." Health psychology : official journal of the Division of Health Psychology, American Psychological Association 35.1 (January 2016): 29-40.
PMID
26030307
Source
epmc
Published In
Health Psychology
Volume
35
Issue
1
Publish Date
2016
Start Page
29
End Page
40
DOI
10.1037/hea0000221

Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being.

We examined the effects of an enhanced informal caregiver training (Enhanced-CT) protocol in cancer symptom and caregiver stress management to caregivers of hospitalized cancer patients.We recruited adult patients in oncology units and their informal caregivers. We utilized a two-armed, randomized controlled trial design with data collected at baseline, post-training, and at 2 and 4 weeks after hospital discharge. Primary outcomes were self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving. Secondary outcomes were caregiver depression, anxiety, and burden. The education comparison (EDUC) group received information about community resources. We used general linear models to test for differences in the Enhanced-CT relative to the EDUC group.We consented and randomized 138 dyads: Enhanced-CT = 68 and EDUC = 70. The Enhanced-CT group had a greater increase in caregiver self-efficacy for cancer symptom management and stress management and preparation for caregiving at the post-training assessment compared to the EDUC group but not at 2- and 4-week post-discharge assessments. There were no intervention group differences in depression, anxiety, and burden.An Enhanced-CT protocol resulted in short-term improvements in self-efficacy for managing patients' cancer symptoms and caregiver stress and preparedness for caregiving but not in caregivers' psychological well-being. The lack of sustained effects may be related to the single-dose nature of our intervention and the changing needs of informal caregivers after hospital discharge.

Authors
Hendrix, CC; Bailey, DE; Steinhauser, KE; Olsen, MK; Stechuchak, KM; Lowman, SG; Schwartz, AJ; Riedel, RF; Keefe, FJ; Porter, LS; Tulsky, JA
MLA Citation
Hendrix, CC, Bailey, DE, Steinhauser, KE, Olsen, MK, Stechuchak, KM, Lowman, SG, Schwartz, AJ, Riedel, RF, Keefe, FJ, Porter, LS, and Tulsky, JA. "Effects of enhanced caregiver training program on cancer caregiver's self-efficacy, preparedness, and psychological well-being." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 24.1 (January 2016): 327-336.
PMID
26062925
Source
epmc
Published In
Supportive Care in Cancer
Volume
24
Issue
1
Publish Date
2016
Start Page
327
End Page
336
DOI
10.1007/s00520-015-2797-3

A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Olsen, M; Zafar, SY; Uronis, H
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Olsen, M, Zafar, SY, and Uronis, H. "A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer." Psycho-Oncology (2016): n/a-n/a.
Source
crossref
Published In
Psycho-Oncology
Publish Date
2016
Start Page
n/a
End Page
n/a
DOI
10.1002/pon.4121

The Communal Coping Model of Pain Catastrophizing in Daily Life: A Within-Couples Daily Diary Study.

The Communal Coping Model characterizes pain catastrophizing as a coping tactic whereby pain expression elicits assistance and empathic responses from others. Married couples (N = 105 couples; 1 spouse with chronic low back pain) completed electronic daily diary assessments 5 times/day for 14 days. In these diaries, patients reported pain catastrophizing, pain, and function, and perceived spouse support, perceived criticism, and perceived hostility. Non-patient spouses reported on their support, criticism, and hostility directed toward patients, as well as their observations of patient pain and pain behaviors. Hierarchical linear modeling tested concurrent and lagged (3 hours later) relationships. Principal findings included the following: a) within-person increases in pain catastrophizing were positively associated with spouse reports of patient pain behavior in concurrent and lagged analyses; b) within-person increases in pain catastrophizing were positively associated with patient perceptions of spouse support, criticism, and hostility in concurrent analyses; c) within-person increases in pain catastrophizing were negatively associated with spouse reports of criticism and hostility in lagged analyses. Spouses reported patient behaviors that were tied to elevated pain catastrophizing, and spouses changed their behavior during and after elevated pain catastrophizing episodes. Pain catastrophizing may affect the interpersonal environment of patients and spouses in ways consistent with the Communal Coping Model.Pain catastrophizing may represent a coping response by which individuals' pain expression leads to assistance or empathic responses from others. Results of the present study support this Communal Coping Model, which emphasizes interpersonal processes by which pain catastrophizing, pain, pain behavior, and responses of significant others are intertwined.

Authors
Burns, JW; Gerhart, JI; Post, KM; Smith, DA; Porter, LS; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Post, KM, Smith, DA, Porter, LS, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "The Communal Coping Model of Pain Catastrophizing in Daily Life: A Within-Couples Daily Diary Study." The journal of pain : official journal of the American Pain Society 16.11 (November 2015): 1163-1175.
PMID
26320945
Source
epmc
Published In
The Journal of Pain
Volume
16
Issue
11
Publish Date
2015
Start Page
1163
End Page
1175
DOI
10.1016/j.jpain.2015.08.005

Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers.

Patients often struggle to express their emotional concerns to their oncology providers and may therefore experience unmet needs. This paper describes the development and implementation of an online program that teaches patients how to communicate their emotions to their oncology providers.The intervention was developed by a multidisciplinary team consisting of palliative care physicians, psychologists, and an intervention software developer and included input from patients. It incorporated elements of Social Cognitive Theory and validated cognitive behavioral strategies for communication skills training. Strategies to increase intervention adherence were implemented midway through the study.The intervention consists of four interactive, online modules to teach patients strategies for expressing emotional concerns to their providers and asking for support. In addition to skill-building, the intervention was designed to raise patients' expectations that expressing emotional concerns to providers would be helpful, to enhance their self-efficacy for doing so, and to help them overcome barriers to having these conversations. After implementing strategies to improve adherence, usage rates increased from 47 to 64 %.This intervention addresses an unmet educational need for patients with advanced cancer. Strategies to increase adherence led to improvements in usage rates in this population of older patients. We are currently evaluating the intervention in a randomized clinical trial to determine its efficacy in increasing patient expression of emotional concerns and requests for support. If successful, this intervention could serve as a model for future online patient education programs.

Authors
Porter, LS; Pollak, KI; Farrell, D; Cooper, M; Arnold, RM; Jeffreys, AS; Tulsky, JA
MLA Citation
Porter, LS, Pollak, KI, Farrell, D, Cooper, M, Arnold, RM, Jeffreys, AS, and Tulsky, JA. "Development and implementation of an online program to improve how patients communicate emotional concerns to their oncology providers." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 23.10 (October 2015): 2907-2916.
PMID
25701437
Source
epmc
Published In
Supportive Care in Cancer
Volume
23
Issue
10
Publish Date
2015
Start Page
2907
End Page
2916
DOI
10.1007/s00520-015-2656-2

Emotional arousal predicts observed social support in German and American couples talking about breast cancer.

Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process.

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional arousal predicts observed social support in German and American couples talking about breast cancer." Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) 29.5 (October 2015): 744-754.
PMID
26075737
Source
epmc
Published In
Journal of Family Psychology
Volume
29
Issue
5
Publish Date
2015
Start Page
744
End Page
754
DOI
10.1037/fam0000092

Development and Initial Validation of the PROMIS(®) Sexual Function and Satisfaction Measures Version 2.0.

The Patient-Reported Outcomes Measurement Information System (PROMIS)(®) Sexual Function and Satisfaction measure (SexFS) version 1.0 was developed with cancer populations. There is a need to expand the SexFS and provide evidence of its validity in diverse populations.The aim of this study was to describe the development of the SexFS v2.0 and present preliminary evidence for its validity.Development built on version 1.0, plus additional review of extant items, discussions with 15 clinical experts, 11 patient focus groups (including individuals with diabetes, heart disease, anxiety, depression, and/or are lesbian, gay, bisexual, or aged 65 or older), 48 cognitive interviews, and psychometric evaluation in a random sample of U.S. adults plus an oversample for specific sexual problems (2281 men, 1686 women). We examined differential item functioning (DIF) by gender and sexual activity. We examined convergent and known-groups validity.The final set of domains includes 11 scored scales (interest in sexual activity, lubrication, vaginal discomfort, clitoral discomfort, labial discomfort, erectile function, orgasm ability, orgasm pleasure, oral dryness, oral discomfort, satisfaction), and six nonscored item pools (screeners, sexual activities, anal discomfort, therapeutic aids, factors interfering with sexual satisfaction, bother). Domains from version 1.0 were reevaluated and improved. Domains considered applicable across gender and sexual activity status, namely interest, orgasm, and satisfaction, were found to have significant DIF. We identified subsets of items in each domain that provided consistent measurement across these important respondent groups. Convergent and known-groups validity was supported.The SexFS version 2.0 has several improvements and enhancements over version 1.0 and other extant measures, including expanded evidence for validity, scores centered around norms for sexually active U.S. adults, new domains, and a final set of items applicable for both men and women and those sexually active with a partner and without. The SexFS is customizable, allowing users to select relevant domains and items for their study.

Authors
Weinfurt, KP; Lin, L; Bruner, DW; Cyranowski, JM; Dombeck, CB; Hahn, EA; Jeffery, DD; Luecht, RM; Magasi, S; Porter, LS; Reese, JB; Reeve, BB; Shelby, RA; Smith, AW; Willse, JT; Flynn, KE
MLA Citation
Weinfurt, KP, Lin, L, Bruner, DW, Cyranowski, JM, Dombeck, CB, Hahn, EA, Jeffery, DD, Luecht, RM, Magasi, S, Porter, LS, Reese, JB, Reeve, BB, Shelby, RA, Smith, AW, Willse, JT, and Flynn, KE. "Development and Initial Validation of the PROMIS(®) Sexual Function and Satisfaction Measures Version 2.0." The journal of sexual medicine 12.9 (September 7, 2015): 1961-1974.
PMID
26346418
Source
epmc
Published In
The Journal of Sexual Medicine
Volume
12
Issue
9
Publish Date
2015
Start Page
1961
End Page
1974
DOI
10.1111/jsm.12966

Anger Arousal and Behavioral Anger Regulation in Everyday Life Among People With Chronic Low Back Pain: Relationships With Spouse Responses and Negative Affect

© 2015 APA, all rights reserved).Objective: To determine the degree to which anger arousal and anger regulation (expression, inhibition) in the daily lives of people with chronic pain were related to spouse support, criticism, and hostility as perceived by patients and as reported by spouses. Method: Married couples (N = 105, 1 spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. On these diaries, patients completed items on their own anger arousal, anger expression, and inhibition, and on perceived spouse support, criticism, and hostility. Spouses reported on their responses toward patients and their negative affect. Hierarchical linear modeling tested concurrent and lagged relationships. Results: Patient-reported increases in anger arousal and anger expression were predominantly related to concurrent decreases in patient-perceived and spouse-reported spouse support, concurrent increases in patient-perceived and spouse-reported spouse criticism and hostility, and increases in spouse-reported negative affect. Relationships for anger expression remained significant with anger arousal controlled. These effects were especially strong for male patients. Spouses reported greater negative affect when patients were present than when they were not. Conclusions: Social support may facilitate adjustment to chronic pain, with declining support and overt criticism and hostility possibly adversely impacting pain and function. Results suggest that patient anger arousal and expression may be related to a negative interpersonal environment for married couples coping with chronic low back pain. (PsycINFO Database Record

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Post, KM; Smith, DA; Porter, LS; Schuster, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Post, KM, Smith, DA, Porter, LS, Schuster, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger Arousal and Behavioral Anger Regulation in Everyday Life Among People With Chronic Low Back Pain: Relationships With Spouse Responses and Negative Affect (Accepted)." Health Psychology (June 1, 2015).
Source
scopus
Published In
Health Psychology
Publish Date
2015
DOI
10.1037/hea0000221

A brief relaxation intervention for pain delivered by palliative care physicians: A pilot study.

Authors
Pollak, KI; Lyna, P; Bilheimer, A; Porter, LS
MLA Citation
Pollak, KI, Lyna, P, Bilheimer, A, and Porter, LS. "A brief relaxation intervention for pain delivered by palliative care physicians: A pilot study." Palliative medicine 29.6 (June 2015): 569-570.
PMID
25680379
Source
epmc
Published In
Palliative Medicine
Volume
29
Issue
6
Publish Date
2015
Start Page
569
End Page
570
DOI
10.1177/0269216315570410

Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function.

The objective of this study was to determine the degree to which patient anger arousal and behavioral anger regulation (expression, inhibition) occurring in the course of daily life was related to patient pain and function as rated by patients and their spouses.Married couples (N = 105) (one spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. Patients completed items on their own state anger, behavioral anger expression and inhibition, and pain-related factors. Spouses completed items on their observations of patient pain-related factors. Hierarchical linear modeling was used to test concurrent and lagged relationships.Patient-reported increases in state anger were related to their reports of concurrent increases in pain and pain interference and to spouse reports of patient pain and pain behavior. Patient-reported increases in behavioral anger expression were related to lagged increases in pain intensity and interference and decreases in function. Most of these relationships remained significant with state anger controlled. Patient-reported increases in behavioral anger inhibition were related to concurrent increases in pain interference and decreases in function, which also remained significant with state anger controlled. Patient-reported increases in state anger were related to lagged increases in spouse reports of patient pain intensity and pain behaviors.Results indicate that in patients with chronic pain, anger arousal and behavioral anger expression and inhibition in everyday life are related to elevated pain intensity and decreased function as reported by patients. Spouse ratings show some degree of concordance with patient reports.

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Peterson, KM; Smith, DA; Porter, LS; Schuster, E; Kinner, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Peterson, KM, Smith, DA, Porter, LS, Schuster, E, Kinner, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function." Health psychology : official journal of the Division of Health Psychology, American Psychological Association 34.5 (May 2015): 547-555.
PMID
25110843
Source
epmc
Published In
Health Psychology
Volume
34
Issue
5
Publish Date
2015
Start Page
547
End Page
555
DOI
10.1037/hea0000091

Automated Internet-based pain coping skills training to manage osteoarthritis pain: a randomized controlled trial.

Osteoarthritis (OA) places a significant burden on worldwide public health because of the large and growing number of people affected by OA and its associated pain and disability. Pain coping skills training (PCST) is an evidence-based intervention targeting OA pain and disability. To reduce barriers that currently limit access to PCST, we developed an 8-week, automated, Internet-based PCST program called PainCOACH and evaluated its potential efficacy and acceptability in a small-scale, 2-arm randomized controlled feasibility trial. Participants were 113 men and women with clinically confirmed hip or knee OA and associated pain. They were randomized to a group completing PainCOACH or an assessment-only control group. Osteoarthritis pain, pain-related interference with functioning, pain-related anxiety, self-efficacy for pain management, and positive and negative affect were measured before intervention, midway through the intervention, and after intervention. Findings indicated high acceptability and adherence: 91% of participants randomized to complete PainCOACH finished all 8 modules over 8 to 10 weeks. Linear mixed models showed that, after treatment, women who received the PainCOACH intervention reported significantly lower pain than that in women in the control group (Cohen d = 0.33). Intervention effects could not be tested in men because of their low pain and small sample size. Additionally, both men and women demonstrated increases in self-efficacy from baseline to after intervention compared with the control group (d = 0.43). Smaller effects were observed for pain-related anxiety (d = 0.20), pain-related interference with functioning (d = 0.13), negative affect (d = 0.10), and positive affect (d = 0.24). Findings underscore the value of continuing to develop an automated Internet-based approach to disseminate this empirically supported intervention.

Authors
Rini, C; Porter, LS; Somers, TJ; McKee, DC; DeVellis, RF; Smith, M; Winkel, G; Ahern, DK; Goldman, R; Stiller, JL; Mariani, C; Patterson, C; Jordan, JM; Caldwell, DS; Keefe, FJ
MLA Citation
Rini, C, Porter, LS, Somers, TJ, McKee, DC, DeVellis, RF, Smith, M, Winkel, G, Ahern, DK, Goldman, R, Stiller, JL, Mariani, C, Patterson, C, Jordan, JM, Caldwell, DS, and Keefe, FJ. "Automated Internet-based pain coping skills training to manage osteoarthritis pain: a randomized controlled trial." Pain 156.5 (May 2015): 837-848.
PMID
25734997
Source
epmc
Published In
PAIN
Volume
156
Issue
5
Publish Date
2015
Start Page
837
End Page
848
DOI
10.1097/j.pain.0000000000000121

Advancing the science of mind-body interventions: a comment on Larkey et al.

Authors
Porter, LS
MLA Citation
Porter, LS. "Advancing the science of mind-body interventions: a comment on Larkey et al." Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 49.2 (April 2015): 149-150.
PMID
25228455
Source
epmc
Published In
Annals of Behavioral Medicine
Volume
49
Issue
2
Publish Date
2015
Start Page
149
End Page
150
DOI
10.1007/s12160-014-9652-5

EMPOWER: An intervention to address barriers to pain management in hospice

© 2015 American Academy of Hospice and Palliative Medicine.Context. Concerns about pain medications are major barriers to pain management in hospice, but few studies have focused on systematic methods to address these concerns.Objectives. The objective of this study was to test the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention, which included hospice staff education, staff screening of barriers to pain management at admission, and discussion about misunderstandings regarding pain management with family caregivers and patients.Methods. We conducted a pilot, cluster randomized, controlled trial with four hospices. One hundred twenty-six family caregivers (55 interventions and 71 controls) were interviewed at two weeks after admission. If patients survived three months after admission, caregivers were reinterviewed.Results. At two weeks, caregivers in the intervention group reported better knowledge about pain management (P = 0.001), fewer concerns about pain and pain medications (P = 0.008), and lower patient pain over the past week (P = 0.014) and trended toward improvement in most other areas under study. Exploratory analyses suggest that EMPOWER had a greater effect for black subjects (vs. whites) on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes.Conclusion. EMPOWER is a promising model to reduce barriers to pain management in hospice.

Authors
Cagle, JG; Zimmerman, S; Cohen, LW; Porter, LS; Hanson, LC; Reed, D
MLA Citation
Cagle, JG, Zimmerman, S, Cohen, LW, Porter, LS, Hanson, LC, and Reed, D. "EMPOWER: An intervention to address barriers to pain management in hospice." Journal of Pain and Symptom Management 49.1 (January 1, 2015): 1-12.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
49
Issue
1
Publish Date
2015
Start Page
1
End Page
12
DOI
10.1016/j.jpainsymman.2014.05.007

EMPOWER: an intervention to address barriers to pain management in hospice.

Concerns about pain medications are major barriers to pain management in hospice, but few studies have focused on systematic methods to address these concerns.The objective of this study was to test the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention, which included hospice staff education, staff screening of barriers to pain management at admission, and discussion about misunderstandings regarding pain management with family caregivers and patients.We conducted a pilot, cluster randomized, controlled trial with four hospices. One hundred twenty-six family caregivers (55 interventions and 71 controls) were interviewed at two weeks after admission. If patients survived three months after admission, caregivers were reinterviewed.At two weeks, caregivers in the intervention group reported better knowledge about pain management (P = 0.001), fewer concerns about pain and pain medications (P = 0.008), and lower patient pain over the past week (P = 0.014) and trended toward improvement in most other areas under study. Exploratory analyses suggest that EMPOWER had a greater effect for black subjects (vs. whites) on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes.EMPOWER is a promising model to reduce barriers to pain management in hospice.

Authors
Cagle, JG; Zimmerman, S; Cohen, LW; Porter, LS; Hanson, LC; Reed, D
MLA Citation
Cagle, JG, Zimmerman, S, Cohen, LW, Porter, LS, Hanson, LC, and Reed, D. "EMPOWER: an intervention to address barriers to pain management in hospice." Journal of pain and symptom management 49.1 (January 2015): 1-12.
PMID
24880000
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
49
Issue
1
Publish Date
2015
Start Page
1
End Page
12
DOI
10.1016/j.jpainsymman.2014.05.007

Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function

© 2014 American Psychological Association.Objective: The objective of this study was to determine the degree to which patient anger arousal and behavioral anger regulation (expression, inhibition) occurring in the course of daily life was related to patient pain and function as rated by patients and their spouses. Method: Married couples (N = 105) (one spouse with chronic low back pain) completed electronic daily diaries, with assessments 5 times/day for 14 days. Patients completed items on their own state anger, behavioral anger expression and inhibition, and pain-related factors. Spouses completed items on their observations of patient pain-related factors. Hierarchical linear modeling was used to test concurrent and lagged relationships. Results: Patient-reported increases in state anger were related to their reports of concurrent increases in pain and pain interference and to spouse reports of patient pain and pain behavior. Patient-reported increases in behavioral anger expression were related to lagged increases in pain intensity and interference and decreases in function. Most of these relationships remained significant with state anger controlled. Patient-reported increases in behavioral anger inhibition were related to concurrent increases in pain interference and decreases in function, which also remained significant with state anger controlled. Patient-reported increases in state anger were related to lagged increases in spouse reports of patient pain intensity and pain behaviors. Conclusions: Results indicate that in patients with chronic pain, anger arousal and behavioral anger expression and inhibition in everyday life are related to elevated pain intensity and decreased function as reported by patients. Spouse ratings show some degree of concordance with patient reports.

Authors
Burns, JW; Gerhart, JI; Bruehl, S; Peterson, KM; Smith, DA; Porter, LS; Schuster, E; Kinner, E; Buvanendran, A; Fras, AM; Keefe, FJ
MLA Citation
Burns, JW, Gerhart, JI, Bruehl, S, Peterson, KM, Smith, DA, Porter, LS, Schuster, E, Kinner, E, Buvanendran, A, Fras, AM, and Keefe, FJ. "Anger arousal and behavioral anger regulation in everyday life among patients with chronic low back pain: Relationships to patient pain and function." Health Psychology 34.5 (2015): 547-555.
Source
scival
Published In
Health Psychology
Volume
34
Issue
5
Publish Date
2015
Start Page
547
End Page
555
DOI
10.1037/hea0000091

Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer

© 2015 APA, all rights reserved).Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process. (PsycINFO Database Record

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer." Journal of Family Psychology (2015).
Source
scival
Published In
Journal of Family Psychology
Publish Date
2015
DOI
10.1037/fam0000092

Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer

© 2015 APA, all rights reserved).Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process. (PsycINFO Database Record

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer." Journal of Family Psychology (2015).
Source
scival
Published In
Journal of Family Psychology
Publish Date
2015
DOI
10.1037/fam0000092

Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer

© 2015 APA, all rights reserved).Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process. (PsycINFO Database Record

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer." Journal of Family Psychology (2015).
Source
scival
Published In
Journal of Family Psychology
Publish Date
2015
DOI
10.1037/fam0000092

Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer

© 2015 APA, all rights reserved).Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process. (PsycINFO Database Record

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer." Journal of Family Psychology (2015).
Source
scival
Published In
Journal of Family Psychology
Publish Date
2015
DOI
10.1037/fam0000092

Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer

© 2015 APA, all rights reserved).Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process. (PsycINFO Database Record

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional Arousal Predicts Observed Social Support in German and American Couples Talking About Breast Cancer." Journal of Family Psychology (2015).
Source
scival
Published In
Journal of Family Psychology
Publish Date
2015
DOI
10.1037/fam0000092

Emotional arousal predicts observed social support in german and american couples talking about breast cancer

© 2015 American Psychological Association.Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury&Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process.

Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, MS, Baucom, DH, Baucom, BR, Weusthoff, S, Hahlweg, K, Atkins, DC, Porter, LS, and Zimmermann, T. "Emotional arousal predicts observed social support in german and american couples talking about breast cancer." Journal of Family Psychology 29.5 (2015): 744-754.
Source
scival
Published In
Journal of Family Psychology
Volume
29
Issue
5
Publish Date
2015
Start Page
744
End Page
754

Retaining critical therapeutic elements of behavioral interventions translated for delivery via the Internet: recommendations and an example using pain coping skills training.

Evidence supporting the efficacy of behavioral interventions based on principles of cognitive behavioral therapies has spurred interest in translating these interventions for delivery via the Internet. However, the benefits of this dissemination method cannot be realized unless the translated interventions are as effective as possible. We describe a challenge that must be overcome to ensure this occurs--Internet interventions must retain therapeutic components and processes underlying the success of face-to-face interventions on which they are based. These components and processes vary in the ease with which they can be translated to the online environment. Moreover, some are subtle and may be overlooked, despite being recognized as essential to the success of face-to-face interventions. We provide preliminary guidance for retaining critical therapeutic components and processes in the translation process, using Pain Coping Skills Training for osteoarthritis pain to illustrate methods. Directions for future research are also discussed.

Authors
Rini, C; Porter, LS; Somers, TJ; McKee, DC; Keefe, FJ
MLA Citation
Rini, C, Porter, LS, Somers, TJ, McKee, DC, and Keefe, FJ. "Retaining critical therapeutic elements of behavioral interventions translated for delivery via the Internet: recommendations and an example using pain coping skills training." Journal of medical Internet research 16.12 (December 19, 2014): e245-.
PMID
25532216
Source
epmc
Published In
Journal of Medical Internet Research
Volume
16
Issue
12
Publish Date
2014
Start Page
e245
DOI
10.2196/jmir.3374

Couples and breast cancer: women's mood and partners' marital satisfaction predicting support perception.

Women who are diagnosed with breast cancer can experience an array of psychosocial difficulties; however, social support, particularly from a spouse, has been shown to have a protective function during this time. This study examined the ways in which a woman's daily mood, pain, and fatigue, and her spouse's marital satisfaction predict the woman's report of partner support in the context of breast cancer. Pretest data from a larger intervention study and multilevel modeling were used to examine the effects of women's daily mood, pain, and fatigue and average levels of mood, pain, and fatigue on women's report of social support received from her partner, as well as how the effects of mood interacted with partners' marital satisfaction. Results show that on days in which women reported higher levels of negative or positive mood, as well as on days they reported more pain and fatigue, they reported receiving more support. Women who, on average, reported higher levels of positive mood tended to report receiving more support than those who, on average, reported lower positive mood. However, average levels of negative mood were not associated with support. Higher average levels of fatigue but not pain were associated with higher support. Finally, women whose husbands reported higher levels of marital satisfaction reported receiving more partner support, but husbands' marital satisfaction did not moderate the effect of women's mood on support. Implications of these findings are discussed relative to assisting couples during this difficult time in their lives.

Authors
Boeding, SE; Pukay-Martin, ND; Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Keefe, FJ
MLA Citation
Boeding, SE, Pukay-Martin, ND, Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, and Keefe, FJ. "Couples and breast cancer: women's mood and partners' marital satisfaction predicting support perception." Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) 28.5 (October 2014): 675-683.
PMID
25133643
Source
epmc
Published In
Journal of Family Psychology
Volume
28
Issue
5
Publish Date
2014
Start Page
675
End Page
683
DOI
10.1037/fam0000019

A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer

Authors
Reese, JB; Porter, LS; Regan, KR; Keefe, FJ; Azad, NS; Diaz, LA; Herman, JM; Haythornthwaite, JA
MLA Citation
Reese, JB, Porter, LS, Regan, KR, Keefe, FJ, Azad, NS, Diaz, LA, Herman, JM, and Haythornthwaite, JA. "A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer." Psycho-Oncology 23.9 (September 2014): 1005-1013.
Source
crossref
Published In
Psycho-Oncology
Volume
23
Issue
9
Publish Date
2014
Start Page
1005
End Page
1013
DOI
10.1002/pon.3508

A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer.

We previously developed and piloted a telephone-based intimacy enhancement (IE) intervention addressing sexual concerns of colorectal cancer patients and their partners in an uncontrolled study. The current study tested the feasibility, acceptability, and preliminary efficacy of the IE intervention in a randomized, controlled trial.Twenty-three couples were randomized to either the four-session IE condition or to a wait list control condition and completed sexual and relationship outcomes measures. The IE intervention teaches skills for coping with sexual concerns and improving intimacy. Feasibility and acceptability were assessed through enrollment and post-treatment program evaluations, respectively. Effect sizes were calculated by comparing differences in average pre/post change scores across completers in the two groups (n = 18 couples).Recruitment and attrition data supported feasibility. Program evaluations for process (e.g., ease of participation) and content (e.g., relevance) demonstrated acceptability. Engaging in intimacy-building activities and communication were the skills rated as most commonly practiced and most helpful. For patients, positive effects of the IE intervention were found for female and male sexual function, medical impact on sexual function, and self-efficacy for enjoying intimacy (≥.58); no effects were found on sexual distress or intimacy and small negative effects for sexual communication, and two self-efficacy items. For partners, positive IE effects were found for all outcomes; the largest were for sexual distress (.69), male sexual function (1.76), communication (.97), and two self-efficacy items (≥.87).The telephone-based IE intervention shows promise for couples facing colorectal cancer. Larger multi-site intervention studies are necessary to replicate findings.

Authors
Barsky Reese, J; Porter, LS; Regan, KR; Keefe, FJ; Azad, NS; Diaz, LA; Herman, JM; Haythornthwaite, JA
MLA Citation
Barsky Reese, J, Porter, LS, Regan, KR, Keefe, FJ, Azad, NS, Diaz, LA, Herman, JM, and Haythornthwaite, JA. "A randomized pilot trial of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer." Psycho-oncology 23.9 (September 2014): 1005-1013.
PMID
24615831
Source
epmc
Published In
Psycho-Oncology
Volume
23
Issue
9
Publish Date
2014
Start Page
1005
End Page
1013
DOI
10.1002/pon.3508

IMPROVING ADHERENCE TO A WEB-BASED INTERVENTION TO HELP ADVANCED CANCER PATIENTS EXPRESS EMOTIONAL CONCERNS

Authors
Pollak, KI; Porter, LS; Farrell, D; Lowman, SG; Jeffreys, A; Tulsky, JA
MLA Citation
Pollak, KI, Porter, LS, Farrell, D, Lowman, SG, Jeffreys, A, and Tulsky, JA. "IMPROVING ADHERENCE TO A WEB-BASED INTERVENTION TO HELP ADVANCED CANCER PATIENTS EXPRESS EMOTIONAL CONCERNS." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S98-S98.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S98
End Page
S98

Development and preliminary evaluation of a telephone-based mindfulness training intervention for survivors of critical illness.

RATIONALE: Persistent symptoms of psychological distress represent an unmet need among intensive care unit (ICU) survivors. OBJECTIVES: We aimed to develop and pilot test a simple telephone-based mindfulness training intervention to address this population's unique needs. METHODS: Open trial involving survivors of medical and surgical critical illness and their informal caregivers, using a pretest-posttest design. MEASUREMENTS AND MAIN RESULTS: We developed a six-session, telephone-delivered, ICU survivor-specific mindfulness intervention based on past focus groups, the medical literature, and the precedent of the most effective components of existing mindfulness programs. A total of 11 survivors of mechanical ventilation were enrolled, together with 2 informal caregivers for exploratory purposes. Three patients dropped out before intervention initiation because of progressive illness or severe social stressors. Of the 10 remaining participants, 8 (80%) completed the program within 7 weeks. Among these eight patients and caregivers who completed all study procedures, six (75%) experienced improvement in symptoms of psychological distress (anxiety, depression, or post-traumatic stress disorder). Changes in distress symptoms were correlated with improvement in mindfulness qualities, adaptive coping, and emotion regulation. Participants reported high satisfaction with the program in postintervention interviews. CONCLUSIONS: A new ICU survivor-specific mindfulness training intervention delivered by telephone was acceptable and feasible. Changes in symptoms of distress were correlated with changes in skills that were targeted by the mindfulness program. Controlled trials are needed to further evaluate this promising intervention.

Authors
Cox, CE; Porter, LS; Buck, PJ; Hoffa, M; Jones, D; Walton, B; Hough, CL; Greeson, JM
MLA Citation
Cox, CE, Porter, LS, Buck, PJ, Hoffa, M, Jones, D, Walton, B, Hough, CL, and Greeson, JM. "Development and preliminary evaluation of a telephone-based mindfulness training intervention for survivors of critical illness." Ann Am Thorac Soc 11.2 (February 2014): 173-181.
PMID
24303911
Source
pubmed
Published In
Annals of the American Thoracic Society
Volume
11
Issue
2
Publish Date
2014
Start Page
173
End Page
181
DOI
10.1513/AnnalsATS.201308-283OC

Couples and breast cancer: Women's mood and partners' marital satisfaction predicting support perception

© 2014 American Psychological Association.Women who are diagnosed with breast cancer can experience an array of psychosocial difficulties; however, social support, particularly from a spouse, has been shown to have a protective function during this time. This study examined the ways in which a woman's daily mood, pain, and fatigue, and her spouse's marital satisfaction predict the woman's report of partner support in the context of breast cancer. Pretest data from a larger intervention study and multilevel modeling were used to examine the effects of women's daily mood, pain, and fatigue and average levels of mood, pain, and fatigue on women's report of social support received from her partner, as well as how the effects of mood interacted with partners' marital satisfaction. Results show that on days in which women reported higher levels of negative or positive mood, as well as on days they reported more pain and fatigue, they reported receiving more support. Women who, on average, reported higher levels of positive mood tended to report receiving more support than those who, on average, reported lower positive mood. However, average levels of negative mood were not associated with support. Higher average levels of fatigue but not pain were associated with higher support. Finally, women whose husbands reported higher levels of marital satisfaction reported receiving more partner support, but husbands' marital satisfaction did not moderate the effect of women's mood on support. Implications of these findings are discussed relative to assisting couples during this difficult time in their lives.

Authors
Boeding, SE; Pukay-Martin, ND; Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Keefe, FJ
MLA Citation
Boeding, SE, Pukay-Martin, ND, Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, and Keefe, FJ. "Couples and breast cancer: Women's mood and partners' marital satisfaction predicting support perception." Journal of Family Psychology 28.5 (2014): 675-683.
Source
scival
Published In
Journal of Family Psychology
Volume
28
Issue
5
Publish Date
2014
Start Page
675
End Page
683
DOI
10.1037/fam0000019

Psychosocial interventions for managing pain in older adults: outcomes and clinical implications.

Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three psychosocial interventions used with older adults: cognitive behavioural therapy, emotional disclosure, and mind-body interventions (specifically mindfulness-based stress reduction and yoga). The final section of the paper highlights important future directions for work in this area.

Authors
Keefe, FJ; Porter, L; Somers, T; Shelby, R; Wren, AV
MLA Citation
Keefe, FJ, Porter, L, Somers, T, Shelby, R, and Wren, AV. "Psychosocial interventions for managing pain in older adults: outcomes and clinical implications." Br J Anaesth 111.1 (July 2013): 89-94. (Review)
PMID
23794650
Source
pubmed
Published In
BJA: British Journal of Anaesthesia
Volume
111
Issue
1
Publish Date
2013
Start Page
89
End Page
94
DOI
10.1093/bja/aet129

Development of the NIH PROMIS ® Sexual Function and Satisfaction measures in patients with cancer.

INTRODUCTION: We describe the development and validation of the Patient-Reported Outcomes Measurement Information System(®) Sexual Function and Satisfaction (PROMIS(®) SexFS; National Institutes of Health) measures, version 1.0, for cancer populations. AIM: To develop a customizable self-report measure of sexual function and satisfaction as part of the U.S. National Institutes of Health PROMIS Network. METHODS: Our multidisciplinary working group followed a comprehensive protocol for developing psychometrically robust patient-reported outcome measures including qualitative (scale development) and quantitative (psychometric evaluation) development. We performed an extensive literature review, conducted 16 focus groups with cancer patients and multiple discussions with clinicians, and evaluated candidate items in cognitive testing with patients. We administered items to 819 cancer patients. Items were calibrated using item-response theory and evaluated for reliability and validity. MAIN OUTCOME MEASURES: The PROMIS SexFS measures, version 1.0, include 81 items in 11 domains: Interest in Sexual Activity, Lubrication, Vaginal Discomfort, Erectile Function, Global Satisfaction with Sex Life, Orgasm, Anal Discomfort, Therapeutic Aids, Sexual Activities, Interfering Factors, and Screener Questions. RESULTS: In addition to content validity (patients indicate that items cover important aspects of their experiences) and face validity (patients indicate that items measure sexual function and satisfaction), the measure shows evidence for discriminant validity (domains discriminate between groups expected to be different) and convergent validity (strong correlations between scores on PROMIS and scores on conceptually similar older measures of sexual function), as well as favorable test-retest reliability among people not expected to change (interclass correlations from two administrations of the instrument, 1 month apart). CONCLUSIONS: The PROMIS SexFS offers researchers a reliable and valid set of tools to measure self-reported sexual function and satisfaction among diverse men and women. The measures are customizable; researchers can select the relevant domains and items comprising those domains for their study.

Authors
Flynn, KE; Lin, L; Cyranowski, JM; Reeve, BB; Reese, JB; Jeffery, DD; Smith, AW; Porter, LS; Dombeck, CB; Bruner, DW; Keefe, FJ; Weinfurt, KP
MLA Citation
Flynn, KE, Lin, L, Cyranowski, JM, Reeve, BB, Reese, JB, Jeffery, DD, Smith, AW, Porter, LS, Dombeck, CB, Bruner, DW, Keefe, FJ, and Weinfurt, KP. "Development of the NIH PROMIS ® Sexual Function and Satisfaction measures in patients with cancer." J Sex Med 10 Suppl 1 (February 2013): 43-52.
PMID
23387911
Source
pubmed
Published In
The Journal of Sexual Medicine
Volume
10 Suppl 1
Publish Date
2013
Start Page
43
End Page
52
DOI
10.1111/j.1743-6109.2012.02995.x

Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study

Chronic musculoskeletal pain can strain marriages, perhaps even to the point of engendering spouse criticism and hostility directed toward patients. Such negative spouse responses may have detrimental effects on patient well-being. While results of cross-sectional studies support this notion, we extended these efforts by introducing expressed emotion (EE) and interpersonal theoretical perspectives, and by using electronic diary methods to capture both patient and spouse reports in a prospective design. Patients with chronic low back pain (CLBP) and their spouses (N = 105 couples) reported on perceived spouse behavior and patient pain 5 times/day for 14 days using Personal Data Assistants (PDAs). Concurrent and lagged within-couple associations between patient's perceptions of spouse criticism/hostility and patient self-reported pain and spouses' observations of patient pain behaviors revealed that (1) patient perceived spouse criticism and hostility were correlated significantly with pain intensity, and spouse observed patient pain behavior was related significantly with patient perceived hostility at the same time point; (2) patient perceived spouse hostility significantly predicted patient pain intensity 3 hours later, and spouse observed pain behaviors significantly predicted patient perceived spouse hostility 3 hours later. Results support both EE and interpersonal models, and imply that a comprehensive model would combine these conceptualizations to fully illustrate how spouse criticism/hostility and patient pain interact to produce a negative spiral. Given that marital interactions are amenable to clinical intervention, improved insight into how spouse behavior and patient pain are tightly linked will encourage productive translational efforts to target this neglected area.

Authors
Burns, JW; Peterson, KM; Smith, DA; Keefe, FJ; Porter, LS; Schuster, E; Kinner, E
MLA Citation
Burns, JW, Peterson, KM, Smith, DA, Keefe, FJ, Porter, LS, Schuster, E, and Kinner, E. "Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study." Pain 154.12 (January 1, 2013): 2715-2721.
Source
scopus
Published In
PAIN
Volume
154
Issue
12
Publish Date
2013
Start Page
2715
End Page
2721
DOI
10.1016/j.pain.2013.07.053

Outcomes of an Uncertainty Management Intervention in Younger African American and Caucasian Breast Cancer Survivors

Authors
Germino, BB; Mishel, MH; Crandell, J; Porter, L; Blyler, D; Jenerette, C; Gil, KM
MLA Citation
Germino, BB, Mishel, MH, Crandell, J, Porter, L, Blyler, D, Jenerette, C, and Gil, KM. "Outcomes of an Uncertainty Management Intervention in Younger African American and Caucasian Breast Cancer Survivors." ONCOLOGY NURSING FORUM 40.1 (January 2013): 82-92.
PMID
23269773
Source
wos-lite
Published In
Oncology Nursing Forum
Volume
40
Issue
1
Publish Date
2013
Start Page
82
End Page
92
DOI
10.1188/13.ONF.82-92

Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study

Chronic musculoskeletal pain can strain marriages, perhaps even to the point of engendering spouse criticism and hostility directed toward patients. Such negative spouse responses may have detrimental effects on patient well-being. While results of cross-sectional studies support this notion, we extended these efforts by introducing expressed emotion (EE) and interpersonal theoretical perspectives, and by using electronic diary methods to capture both patient and spouse reports in a prospective design. Patients with chronic low back pain (CLBP) and their spouses (N = 105 couples) reported on perceived spouse behavior and patient pain 5 times/day for 14 days using Personal Data Assistants (PDAs). Concurrent and lagged within-couple associations between patient's perceptions of spouse criticism/hostility and patient self-reported pain and spouses' observations of patient pain behaviors revealed that (1) patient perceived spouse criticism and hostility were correlated significantly with pain intensity, and spouse observed patient pain behavior was related significantly with patient perceived hostility at the same time point; (2) patient perceived spouse hostility significantly predicted patient pain intensity 3 hours later, and spouse observed pain behaviors significantly predicted patient perceived spouse hostility 3 hours later. Results support both EE and interpersonal models, and imply that a comprehensive model would combine these conceptualizations to fully illustrate how spouse criticism/hostility and patient pain interact to produce a negative spiral. Given that marital interactions are amenable to clinical intervention, improved insight into how spouse behavior and patient pain are tightly linked will encourage productive translational efforts to target this neglected area. © 2013 International Association for the Study of Pain.

Authors
Burns, JW; Peterson, KM; Smith, DA; Keefe, FJ; Porter, LS; Schuster, E; Kinner, E
MLA Citation
Burns, JW, Peterson, KM, Smith, DA, Keefe, FJ, Porter, LS, Schuster, E, and Kinner, E. "Temporal associations between spouse criticism/hostility and pain among patients with chronic pain: A within-couple daily diary study." Pain (2013).
PMID
23932908
Source
scival
Published In
PAIN
Publish Date
2013
DOI
10.1016/j.pain.2013.07.053

Significant Variation in Provider Discussion of Sexual Side Effects With Radiation Therapy Patients

Authors
Koontz, BF; Flynn, K; Reese, JB; Urdeneta, AI; Moghanaki, D; Porter, LS
MLA Citation
Koontz, BF, Flynn, K, Reese, JB, Urdeneta, AI, Moghanaki, D, and Porter, LS. "Significant Variation in Provider Discussion of Sexual Side Effects With Radiation Therapy Patients." November 1, 2012.
Source
wos-lite
Published In
International Journal of Radiation Oncology, Biology, Physics
Volume
84
Issue
3
Publish Date
2012
Start Page
S210
End Page
S210

Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers.

PURPOSE: Survivors of acute lung injury (ALI) and their informal caregivers have difficulty coping with the physical and emotional challenges of recovery from critical illness. We aimed to develop and pilot test a telephone-based coping skills training intervention for this population. METHODS: Fifty-eight participants were enrolled overall. A total of 21 patients and 23 caregivers participated in a cross-sectional study to assess coping and its association with psychological distress. This also informed the development of an ALI coping skills training intervention in an iterative process involving content and methodological experts. The intervention was then evaluated in seven patients and seven caregivers in an uncontrolled, prospective, pre-post study. Outcomes included acceptability, feasibility, and symptoms of psychological distress measured with the Hospital Anxiety and Depression Scale (HADS) and Post-Traumatic Symptom Scale (PTSS). RESULTS: Survivors and their caregivers used adaptive coping infrequently, a pattern that was strongly associated with psychological distress. These findings informed the development of a 12-session intervention for acquiring, applying, and maintaining coping skills. In the evaluation phase, participants completed 77 (92 %) of a possible 84 telephone sessions and all (100 %) reported the intervention's usefulness in their daily routine. Mean change scores reflecting improvements in the HADS (7.8 U) and PTSS (10.3 U) were associated with adaptive coping (r = 0.50-0.70) and high self-efficacy (r = 0.67-0.79). CONCLUSIONS: A novel telephone-based coping skills training intervention was acceptable, feasible, and may have been associated with a reduction in psychological distress among survivors of ALI and their informal caregivers. A randomized trial is needed to evaluate the intervention.

Authors
Cox, CE; Porter, LS; Hough, CL; White, DB; Kahn, JM; Carson, SS; Tulsky, JA; Keefe, FJ
MLA Citation
Cox, CE, Porter, LS, Hough, CL, White, DB, Kahn, JM, Carson, SS, Tulsky, JA, and Keefe, FJ. "Development and preliminary evaluation of a telephone-based coping skills training intervention for survivors of acute lung injury and their informal caregivers." Intensive Care Med 38.8 (August 2012): 1289-1297.
PMID
22527082
Source
pubmed
Published In
Intensive Care Medicine
Volume
38
Issue
8
Publish Date
2012
Start Page
1289
End Page
1297
DOI
10.1007/s00134-012-2567-3

Partner-assisted emotional disclosure for patients with GI cancer: 8-week follow-up and processes associated with change.

PURPOSE: We recently reported that a partner-assisted emotional disclosure intervention for gastrointestinal cancer led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. The purposes of the present study were to examine outcomes at 8-week follow-up and process variables that may influence treatment effects. METHODS: One hundred thirty couples were randomly assigned to either partner-assisted emotional disclosure or an education/support control condition. Participants completed measures of relationship quality, intimacy, and psychological distress before randomization, post-treatment, and 8 weeks later. Patients in the disclosure intervention completed measures of negative affect immediately following each treatment session, and their level of expressiveness during the sessions was rated by trained observers. Data were analyzed using multilevel modeling. RESULTS: Among couples in which the patient initially reported higher levels of holding back, the disclosure intervention led to improvements in relationship quality and intimacy that were maintained at 8-weeks follow-up. High levels of patient expressiveness during the disclosure sessions were associated with improvements in relationship quality and intimacy, and high levels of patient negative affect immediately following the sessions were associated with reductions in psychological distress at the post-test assessment. CONCLUSIONS: For couples in which the patient tends to hold back from discussing concerns, partner-assisted emotional disclosure is a beneficial intervention leading to improvements in relationship functioning that maintain over time. Future research is needed to examine methods of enhancing intervention effects, including encouraging patient expressiveness and negative affect during the sessions.

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Hurwitz, H; Moser, B; Patterson, E; Kim, HJ
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Hurwitz, H, Moser, B, Patterson, E, and Kim, HJ. "Partner-assisted emotional disclosure for patients with GI cancer: 8-week follow-up and processes associated with change." Support Care Cancer 20.8 (August 2012): 1755-1762.
PMID
21947440
Source
pubmed
Published In
Supportive Care in Cancer
Volume
20
Issue
8
Publish Date
2012
Start Page
1755
End Page
1762
DOI
10.1007/s00520-011-1272-z

Circadian disruption--a new direction for psycho-oncology research? A comment on Dedert et al.

Authors
Porter, LS
MLA Citation
Porter, LS. "Circadian disruption--a new direction for psycho-oncology research? A comment on Dedert et al." Ann Behav Med 44.1 (August 2012): 1-2.
PMID
22585180
Source
pubmed
Published In
Annals of Behavioral Medicine
Volume
44
Issue
1
Publish Date
2012
Start Page
1
End Page
2
DOI
10.1007/s12160-012-9376-3

Patient experiences with communication about sex during and after treatment for cancer.

OBJECTIVE: We studied patients' experiences with oncology providers regarding communication about sexual issues during and after treatment for cancer. METHODS: During development of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) Sexual Function measure, we collected focus group and survey data on communication with oncology professionals about sexual problems. We conducted 16 focus groups with patients and survivors (n = 109) and analyzed the discussions for major themes, including experiences discussing sex during oncology visits. During testing of the PROMIS Sexual Function measure, we assessed experiences discussing sexual problems with oncology professionals (n = 819) and measured bivariate associations between asking for information from clinicians and sexual function and satisfaction with sex life. RESULTS: Most patients and survivors (74%) thought that discussions with oncology professionals about sexual problems were important, but whether they had ever received information about sexual function from a provider varied by cancer type (23% lung, 29% breast, 39% colorectal, and 79% prostate). Those who had asked an oncology professional about sexual problems had significantly greater interest in sexual activity as well as more sexual dysfunction. CONCLUSIONS: Sexual problems are a widespread concern among patients and survivors, but there is much variation in experiences of communication about sexual issues, and many patients do not receive the information they need from their oncology providers. There are large differences in sexual function between patients who do and do not ask providers about sexual problems. Sexual health has yet to be fully integrated into oncology care, even for cancers involving sex organs.

Authors
Flynn, KE; Reese, JB; Jeffery, DD; Abernethy, AP; Lin, L; Shelby, RA; Porter, LS; Dombeck, CB; Weinfurt, KP
MLA Citation
Flynn, KE, Reese, JB, Jeffery, DD, Abernethy, AP, Lin, L, Shelby, RA, Porter, LS, Dombeck, CB, and Weinfurt, KP. "Patient experiences with communication about sex during and after treatment for cancer." Psychooncology 21.6 (June 2012): 594-601.
PMID
21394821
Source
pubmed
Published In
Psycho-Oncology
Volume
21
Issue
6
Publish Date
2012
Start Page
594
End Page
601
DOI
10.1002/pon.1947

Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication.

Partner-assisted emotional disclosure is a couple-based intervention designed to help patients disclose cancer-related concerns to their spouses-partners. We previously found that, compared with an education/support control condition, partner-assisted emotional disclosure led to significant improvements in relationship quality and intimacy for couples in which the patient initially reported holding back from discussing cancer-related concerns (Porter et al., 2009, Cancer, 115, 4326-4338). The purpose of this study was to examine the process data from couples who participated in the disclosure sessions including (a) observational ratings of couples' communication during the sessions; (b) couples' ratings of their communication during the sessions; and (c) associations between participants' observed communication and their baseline psychological/relationship functioning. As rated by trained observers, couples' communication was in the moderate range of adaptive skills. Self-report data indicated that participants had positive perceptions of their communication. Observational and self-report ratings were weakly associated. Patients reporting lower levels of relationship quality, higher levels of holding back, and higher partner avoidance at baseline were rated by observers as more expressive during the sessions. Overall, these findings suggest that the intervention was acceptable to couples and was particularly helpful for patients who had difficulty talking with their partners on their own without skills training.

Authors
Porter, LS; Baucom, DH; Keefe, FJ; Patterson, ES
MLA Citation
Porter, LS, Baucom, DH, Keefe, FJ, and Patterson, ES. "Reactions to a partner-assisted emotional disclosure intervention: direct observation and self-report of patient and partner communication." J Marital Fam Ther 38 Suppl 1 (June 2012): 284-295.
PMID
22765340
Source
pubmed
Published In
Journal of Marital and Family Therapy
Volume
38 Suppl 1
Publish Date
2012
Start Page
284
End Page
295
DOI
10.1111/j.1752-0606.2011.00278.x

SELF-EFFICACY AND PAIN CATASTROPHIZING IN PATIENTS RECEIVING SPINAL CORD STIMULATOR IMPLANTS FOR PERSISTENT PAIN

Authors
Porter, LS; Keefe, F; Williams, D; Patil, P; Huh, B; Edwards, C
MLA Citation
Porter, LS, Keefe, F, Williams, D, Patil, P, Huh, B, and Edwards, C. "SELF-EFFICACY AND PAIN CATASTROPHIZING IN PATIENTS RECEIVING SPINAL CORD STIMULATOR IMPLANTS FOR PERSISTENT PAIN." ANNALS OF BEHAVIORAL MEDICINE 43 (April 2012): S36-S36.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
43
Publish Date
2012
Start Page
S36
End Page
S36

Attachment styles in patients with lung cancer and their spouses: Associations with patient and spouse adjustment

Purpose This study examined attachment styles in patients with lung cancer and their spouses and associations between attachment styles and patient and spouse adjustment. Methods One hundred twenty-seven patients with early stage lung cancer completed measures of attachment style, marital quality, self-efficacy, pain, depression, anxiety, and quality of life. Their spouses completedmeasures of attachment style, marital quality, self-efficacy, caregiver strain, and mood. Results Analyses indicated that, among patients, those high in either attachment anxiety or avoidance had significantly higher levels of anxiety and poorer social well-being. Attachment avoidance was also significantly associated with higher levels of depression and poorer marital quality and functional well-being. Spouse avoidant attachment was significantly associated with patient reports of increased pain and poorer functional well-being, and spouse anxious attachment was associated with poorer patient marital quality. Among spouses, those high in attachment avoidance reported significantly higher levels of caregiver strain, anger, depressed mood, and poorer marital quality; those high in attachment anxiety reported higher anxious mood. Dyads in which both partners were insecurely attached had significantly poorer adjustment compared to dyads in which both partners reported secure attachment. Conclusions These preliminary findings raise the possibility that attachment styles of cancer patients and their spouses as individuals and as a dyad may be important factors affecting adjustment in multiple domains. © 2011 Springer-Verlag .

Authors
Porter, LS; Keefe, FJ; Davis, D; Rumble, M; Scipio, C; Garst, J
MLA Citation
Porter, LS, Keefe, FJ, Davis, D, Rumble, M, Scipio, C, and Garst, J. "Attachment styles in patients with lung cancer and their spouses: Associations with patient and spouse adjustment." Supportive Care in Cancer 20.10 (2012): 2459-2466.
PMID
22246596
Source
scival
Published In
Supportive Care in Cancer
Volume
20
Issue
10
Publish Date
2012
Start Page
2459
End Page
2466
DOI
10.1007/s00520-011-1367-6

Pilot feasibility study of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer

No studies have tested interventions addressing the sexual concerns of colorectal cancer patients and their partners. The authors reported findings from a pilot feasibility study of a novel telephone-based intimacy enhancement protocol that addresses the intimacy and sexual concerns of couples facing colorectal cancer. On the basis of a flexible coping model, the intervention was designed to help couples make cognitive and behavioral shifts in their intimate relationships. Participants were 18 individuals (9 dyads) who completed the intervention and measures of feasibility (frequency, ease of use, helpfulness of skills, ratings of rapport), program evaluations, and measures of sexual and relationship functioning. Most participants reported that the intervention was quite a bit or extremely helpful and that they had used the skills taught within the past week. The skills most commonly practiced and perceived as most helpful tended to be behavioral (e.g., trying a new sexual activity). The authors found the largest effect sizes (.60) for sexual distress, sexual function (female), and sexual communication. Findings from this pilot study suggest that the intimacy enhancement protocol is feasible and holds promise for improving sexual and intimacy outcomes in colorectal cancer patients and their partners. The authors discuss the research and clinical implications. © 2012 Copyright Taylor and Francis Group, LLC.

Authors
Reese, JB; Porter, LS; Somers, TJ; Keefe, FJ
MLA Citation
Reese, JB, Porter, LS, Somers, TJ, and Keefe, FJ. "Pilot feasibility study of a telephone-based couples intervention for physical intimacy and sexual concerns in colorectal cancer." Journal of Sex and Marital Therapy 38.5 (2012): 402-417.
PMID
22900623
Source
scival
Published In
Journal of Sex & Marital Therapy
Volume
38
Issue
5
Publish Date
2012
Start Page
402
End Page
417
DOI
10.1080/0092623X.2011.606886

Men's psychological functioning in the context of women's breast cancer

Previous research indicates that men are affected when their female partners have breast cancer. However, little is known about what predicts men's psychological well-being in this context. The current investigation involved couples in which the woman had early stage breast cancer and explored the degree to which men's positive and negative well-being was related to women's well-being, women's physical symptoms, relationship functioning, and relationship duration. The findings indicate that all of these factors play a role and interact in predicting men's well-being. In particular, when women have a high level of physical symptoms, the typical associations between men's well-being with women's well-being and relationship adjustment no longer persist. Implications for working with couples addressing health problems are provided. © 2010 American Association for Marriage and Family Therapy.

Authors
Baucom, DH; Kirby, JS; Pukay-Martin, ND; Porter, LS; Fredman, SJ; Gremore, TM; Keefe, FJ; Atkins, D
MLA Citation
Baucom, DH, Kirby, JS, Pukay-Martin, ND, Porter, LS, Fredman, SJ, Gremore, TM, Keefe, FJ, and Atkins, D. "Men's psychological functioning in the context of women's breast cancer." Journal of Marital and Family Therapy 38.2 (2012): 317-329.
PMID
22512294
Source
scival
Published In
Journal of Marital and Family Therapy
Volume
38
Issue
2
Publish Date
2012
Start Page
317
End Page
329
DOI
10.1111/j.1752-0606.2009.00133.x

Couple-Based Interventions for Medical Problems

The current paper discusses general principles, therapeutic strategies, common factors, and domains commonly addressed in the treatment of couples who have a partner with a medical condition. Couple-based interventions for medical problems are contrasted with couple therapy and relationship education in that the emphasis is on assisting the patient in addressing the medical disorder, along with being attentive to the patient's partner and their relationship. Guidelines are provided showing how knowledge and understanding of medical disorders and couple functioning are integrated in order to conduct such interventions. Five common domains addressed during intervention are elaborated upon: (a) psychoeducation about the disorder, (b) sharing thoughts and feeling regarding the disorder, (c) making decisions focal to the medical disorder, (d) implementing relationship changes that are nonmedical but that result from the disorder, and (e) addressing relationship functioning unrelated to the disorder. The importance of empirically demonstrating the utility of each domain in future investigations is noted. © 2011.

Authors
Baucom, DH; Porter, LS; Kirby, JS; Hudepohl, J
MLA Citation
Baucom, DH, Porter, LS, Kirby, JS, and Hudepohl, J. "Couple-Based Interventions for Medical Problems." Behavior Therapy 43.1 (2012): 61-76.
PMID
22304879
Source
scival
Published In
Behavior Therapy
Volume
43
Issue
1
Publish Date
2012
Start Page
61
End Page
76
DOI
10.1016/j.beth.2011.01.008

TELEPHONE-BASED COPING SKILLS TRAINING FOR ACUTE LUNG INJURY SURVIVORS & THEIR INFORMAL CAREGIVERS

Authors
Cox, CE; Porter, LS; Hough, CL; Kahn, JM; Carson, SS; Curtis, JR; White, DB; Keefe, FJ
MLA Citation
Cox, CE, Porter, LS, Hough, CL, Kahn, JM, Carson, SS, Curtis, JR, White, DB, and Keefe, FJ. "TELEPHONE-BASED COPING SKILLS TRAINING FOR ACUTE LUNG INJURY SURVIVORS & THEIR INFORMAL CAREGIVERS." INTENSIVE CARE MEDICINE 37 (September 2011): S135-S135.
Source
wos-lite
Published In
Intensive Care Medicine
Volume
37
Publish Date
2011
Start Page
S135
End Page
S135

Psychosocial issues in cancer pain.

Cancer pain is a complex and multidimensional experience that affects and is affected by psychological and social factors. This article reviews recent research that points to a number of key psychosocial factors associated with pain, including psychological distress, coping, and social support, as well as the impact of socioeconomic factors on barriers to pain management. We also review recent research suggesting that psychosocial interventions, including education, coping-skills training, and hypnosis, may be useful adjuncts to medical management of pain. Clinical implications and recommendations for future research are discussed.

Authors
Porter, LS; Keefe, FJ
MLA Citation
Porter, LS, and Keefe, FJ. "Psychosocial issues in cancer pain." Curr Pain Headache Rep 15.4 (August 2011): 263-270. (Review)
PMID
21400251
Source
pubmed
Published In
Current Pain and Headache Reports
Volume
15
Issue
4
Publish Date
2011
Start Page
263
End Page
270
DOI
10.1007/s11916-011-0190-6

Sexual functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS®).

OBJECTIVE: Cancer and treatments for cancer affect specific aspects of sexual functioning and intimacy; however, limited qualitative work has been done in diverse cancer populations. As part of an effort to improve measurement of self-reported sexual functioning, we explored the scope and importance of sexual functioning and intimacy to patients across cancer sites and along the continuum of care. METHODS: We conducted 16 diagnosis- and sex-specific focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics (N=109). A trained note taker produced field notes summarizing the discussions. An independent auditor verified field notes against written transcripts. The content of the discussions was analyzed for major themes by two independent coders. RESULTS: Across all cancers, the most commonly discussed cancer- or treatment-related effects on sexual functioning and intimacy were fatigue, treatment-related hair loss, weight gain and organ loss or scarring. Additional barriers were unique to particular diagnoses, such as shortness of breath in lung cancer, gastrointestinal problems in colorectal cancers and incontinence in prostate cancer. Sexual functioning and intimacy were considered important to quality of life. While most effects of cancer were considered negative, many participants identified improvements to intimacy after cancer. CONCLUSION: Overall evaluations of satisfaction with sex life did not always correspond to specific aspects of functioning (e.g. erectile dysfunction), presenting a challenge to researchers aiming to measure sexual functioning as an outcome. Health-care providers should not assume that level of sexual impairment determines sexual satisfaction and should explore cancer patients' sexual concerns directly.

Authors
Flynn, KE; Jeffery, DD; Keefe, FJ; Porter, LS; Shelby, RA; Fawzy, MR; Gosselin, TK; Reeve, BB; Weinfurt, KP
MLA Citation
Flynn, KE, Jeffery, DD, Keefe, FJ, Porter, LS, Shelby, RA, Fawzy, MR, Gosselin, TK, Reeve, BB, and Weinfurt, KP. "Sexual functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS®)." Psychooncology 20.4 (April 2011): 378-386.
PMID
20878833
Source
pubmed
Published In
Psycho-Oncology
Volume
20
Issue
4
Publish Date
2011
Start Page
378
End Page
386
DOI
10.1002/pon.1738

Pain and emotion: A biopsychosocial review of recent research

Objective and Method: Research on emotion and pain has burgeoned. We review the last decade's literature, focusing on links between emotional processes and persistent pain. Results: Neurobiological research documents the neural processes that distinguish affective from sensory pain dimensions, link emotion and pain, and generate central nervous system pain sensitization. Psychological research demonstrates that greater pain is related to emotional stress and limited emotional awareness, expression, and processing. Social research shows the potential importance of emotional communication, empathy, attachment, and rejection. Conclusions: Emotions are integral to the conceptualization, assessment, and treatment of persistent pain. Research should clarify when to eliminate or attenuate negative emotions, and when to access, experience, and express them. Theory and practice should integrate emotion into cognitive-behavioral models of persistent pain. © 2011 Wiley Periodicals, Inc.

Authors
Lumley, MA; Cohen, JL; Borszcz, GS; Cano, A; Radcliffe, AM; Porter, LS; Schubiner, H; Keefe, FJ
MLA Citation
Lumley, MA, Cohen, JL, Borszcz, GS, Cano, A, Radcliffe, AM, Porter, LS, Schubiner, H, and Keefe, FJ. "Pain and emotion: A biopsychosocial review of recent research." Journal of Clinical Psychology 67.9 (2011): 942-968.
PMID
21647882
Source
scival
Published In
Journal of Clinical Psychology
Volume
67
Issue
9
Publish Date
2011
Start Page
942
End Page
968
DOI
10.1002/jclp.20816

Caregiver-assisted coping skills training for lung cancer: Results of a randomized clinical trial

Context: Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers. Objectives: This study tested the efficacy of a caregiver-assisted CST protocol in a sample of patients with lung cancer. Methods: Two hundred thirty-three lung cancer patients and their caregivers were randomly assigned to receive 14 telephone-based sessions of either caregiver-assisted CST or education/support involving the caregiver. Patients completed measures assessing pain, psychological distress, quality of life (QOL), and self-efficacy for symptom management; caregivers completed measures assessing psychological distress, caregiver strain, and self-efficacy for helping the patient manage symptoms. Results: Patients in both treatment conditions showed improvements in pain, depression, QOL, and self-efficacy, and caregivers in both conditions showed improvements in anxiety and self-efficacy from baseline to four-month follow-up. Results of exploratory analyses suggested that the CST intervention was more beneficial to patients/caregivers with Stage II and III cancers, whereas the education/support intervention was more beneficial to patients/caregivers with Stage I cancer. Conclusion: Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change. © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Porter, LS; Keefe, FJ; Garst, J; Baucom, DH; McBride, CM; McKee, DC; Sutton, L; Carson, K; Knowles, V; Rumble, M; Scipio, C
MLA Citation
Porter, LS, Keefe, FJ, Garst, J, Baucom, DH, McBride, CM, McKee, DC, Sutton, L, Carson, K, Knowles, V, Rumble, M, and Scipio, C. "Caregiver-assisted coping skills training for lung cancer: Results of a randomized clinical trial." Journal of Pain and Symptom Management 41.1 (2011): 1-13.
PMID
20832982
Source
scival
Published In
Journal of Pain and Symptom Management
Volume
41
Issue
1
Publish Date
2011
Start Page
1
End Page
13
DOI
10.1016/j.jpainsymman.2010.04.014

Stress Buffering Effects of Daily Spousal Support on Women's Daily Emotional and Physical Experiences in the Context of Breast Cancer Concerns

Objective: This study examined whether the relationship between daily spousal support and daily psychological and physical outcomes varied as a function of level of breast cancer related concern (stress buffering model). Design: Ninety-five women with early stage breast cancer completed daily reports of emotional and physical experiences and satisfaction with spousal support for 30 days. Women also rated problems dealing with three types of cancer specific concerns: emotional, physical, and social. Main outcome measures: Women's positive and negative affect and cancer related pain and fatigue. Results: Multilevel analyses supported a stress buffering effect for social concerns and a reverse stress buffering effect for emotional and physical concerns. Conclusion: Daily spousal support appears to be an important contributor to the daily emotional and physical wellbeing of women with breast cancer. Contrary to the tenets of the stress buffering model, these data suggest that the buffering effect of spousal support is attenuated when breast cancer related emotional and physical concerns reach high levels. © 2011 American Psychological Association.

Authors
Gremore, TM; Baucom, DH; Porter, LS; Kirby, JS; Atkins, DC; Keefe, FJ
MLA Citation
Gremore, TM, Baucom, DH, Porter, LS, Kirby, JS, Atkins, DC, and Keefe, FJ. "Stress Buffering Effects of Daily Spousal Support on Women's Daily Emotional and Physical Experiences in the Context of Breast Cancer Concerns." Health Psychology 30.1 (2011): 20-30.
PMID
21299291
Source
scival
Published In
Health Psychology
Volume
30
Issue
1
Publish Date
2011
Start Page
20
End Page
30
DOI
10.1037/a0021798

Predictors and patterns of participant adherence to a cortisol collection protocol

Background: Cortisol, a stress-related hormone, has been measured in many psychoimmunological studies via collection of saliva; however, patterns of participant adherence to protocol procedures are rarely described in the literature. Objectives: In this paper we examine adherence to a cortisol morning rise collection protocol and explore its associations with demographic predictors and fatigue. Method: Participants included 262 breast cancer survivors enrolled in a National Institute of Nursing Research funded longitudinal intervention study (5R01NR010190, M. Mishel, P.I.). Self-reported times of salivary cortisol collection were recorded for each of 12 saliva samples. Adherence was assessed with respect to various demographic factors and fatigue. Participants were categorized as having high, moderate, or low adherence to the saliva collection protocol. Results: Overall, 117 (45%) participants had high adherence to the protocol, 117 (45%) participants had moderate adherence, and 28 (∼11%) participants had low adherence. Tests for proportionality for the polytomous logistic regression indicated that demographic predictors in our model had a similar association with each level of participant adherence. Women who did not adhere to the saliva collection were more likely to be African American (OR .50, CI .29-88) and to report a high impact of fatigue on their behaviors (OR .88, CI .79-98). Though other predictors in the model were not statistically significant (working full-time and living with at least one child under 18 years of age), the overall model was significant (χ2(4)=17.35, p<.01). Discussion: To our knowledge, this is the first study to examine profiles of participant adherence to a cortisol sampling protocol over multiple timepoints. By conceptualizing adherence as a polytomous outcome, future studies may give us insights into adherence trends in other populations with the aim of promoting adherence and designing more informed saliva collection protocols. © 2010 Elsevier Ltd.

Authors
Hall, DL; Blyler, D; Allen, D; Mishel, MH; Crandell, J; Germino, BB; Porter, LS
MLA Citation
Hall, DL, Blyler, D, Allen, D, Mishel, MH, Crandell, J, Germino, BB, and Porter, LS. "Predictors and patterns of participant adherence to a cortisol collection protocol." Psychoneuroendocrinology 36.4 (2011): 540-546.
PMID
20863625
Source
scival
Published In
Psychoneuroendocrinology
Volume
36
Issue
4
Publish Date
2011
Start Page
540
End Page
546
DOI
10.1016/j.psyneuen.2010.08.008

Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®)).

OBJECTIVE: Cancer and its treatments disturb sleep-wake functioning; however, there is little information available on the characteristics and consequences of sleep problems associated with cancer. As part of an effort to improve measurement of sleep-wake functioning, we explored the scope of difficulties with sleep in a diverse group of patients diagnosed with cancer. METHODS: We conducted 10 focus groups with patients recruited from the Duke University tumor registry and oncology/hematology clinics. Separate groups were held with patients scheduled to begin or currently undergoing treatment for breast, prostate, lung, colorectal, hematological, and other cancer types and with patients who were in posttreatment follow-up. The content of the focus group discussions was transcribed and analyzed for major themes by independent coders. RESULTS: Participants not only reported causes of sleep disturbance common in other populations, such as pain and restless legs, but they also reported causes that may be unique to cancer populations, including abnormal dreams, anxiety about cancer diagnosis and recurrence, night sweats, and problems with sleep positioning. Many participants felt that sleep problems reduced their productivity, concentration, social interactions, and overall quality of life. Many also shared beliefs about the increased importance of sleep when fighting cancer. CONCLUSIONS: The findings underscore the need for interventions that minimize the negative impact of cancer and its treatments on sleep. This study will inform efforts now underway to develop a patient-reported measure of sleep-wake functioning that reflects the breadth of concepts considered important by patients with cancer.

Authors
Flynn, KE; Shelby, RA; Mitchell, SA; Fawzy, MR; Hardy, NC; Husain, AM; Keefe, FJ; Krystal, AD; Porter, LS; Reeve, BB; Weinfurt, KP
MLA Citation
Flynn, KE, Shelby, RA, Mitchell, SA, Fawzy, MR, Hardy, NC, Husain, AM, Keefe, FJ, Krystal, AD, Porter, LS, Reeve, BB, and Weinfurt, KP. "Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®))." Psychooncology 19.10 (October 2010): 1086-1093.
PMID
20013938
Source
pubmed
Published In
Psycho-Oncology
Volume
19
Issue
10
Publish Date
2010
Start Page
1086
End Page
1093
DOI
10.1002/pon.1664

Sexual concerns in cancer patients: a comparison of GI and breast cancer patients.

PURPOSE: Although sexual concerns have been examined in breast cancer (BC), these concerns remain understudied and undertreated for patients with gastrointestinal (GI) cancer. Objectives were to: (1) assess sexual concerns in GI cancer patients compared with breast cancer patients; (2) examine whether sexual concerns are stable over time in GI and breast cancer patients; and (3) evaluate whether sexual concerns in GI and breast cancer are significantly associated with quality of life, symptom severity, and disease interference, and whether these associations change over time. METHODS: Data were collected from GI and breast cancer patients during four outpatient clinic visits over 6 months. Measures included sexual concerns (reduced sexual enjoyment, interest, or performance), quality of life (FACT-G), symptom severity, disease interference (MD Anderson Symptom Inventory), and disease-related distress (NCCN Distress Scale). Linear mixed model analyses were conducted. RESULTS: Sexual concerns were common in both samples, with 57% of GI cancer patients and 53% of breast cancer patients reporting at least mild sexual concerns. Sexual concerns were stable over time and were significantly associated with lower levels of functioning in multiple domains (e.g., quality of life, symptom severity, disease interference, and disease-related distress), irrespective of length of time since diagnosis. Cancer type (GI/breast cancer) was not a moderator of this relationship. CONCLUSIONS: Self-reported sexual concerns were common, stable, and related significantly to quality of life, symptom severity, disease interference, and disease-related distress for both GI and breast cancer patients. Limitations and implications for future research are discussed.

Authors
Reese, JB; Shelby, RA; Keefe, FJ; Porter, LS; Abernethy, AP
MLA Citation
Reese, JB, Shelby, RA, Keefe, FJ, Porter, LS, and Abernethy, AP. "Sexual concerns in cancer patients: a comparison of GI and breast cancer patients." Support Care Cancer 18.9 (September 2010): 1179-1189.
PMID
19777269
Source
pubmed
Published In
Supportive Care in Cancer
Volume
18
Issue
9
Publish Date
2010
Start Page
1179
End Page
1189
DOI
10.1007/s00520-009-0738-8

Hope in the context of lung cancer: relationships of hope to symptoms and psychological distress.

CONTEXT: Hope may be important in explaining the variability in how patients adjust to lung cancer. OBJECTIVES: The aim of this study was to examine how hope, as conceptualized by Snyder et al., is associated with multiple indices of adjustment to lung cancer. This theoretical model of hope suggests that people with high levels of hope are able to think about the pathways to goals (pathways) and feel confident that they can pursue those pathways to reach their goals (agency). METHODS: We hypothesized that higher levels of hope, as measured by Snyder et al.'s hope scale, would be related to lower levels of pain and other lung cancer symptoms (i.e., fatigue and cough) and lower psychological distress (i.e., depression). Participants in this study included patients with a diagnosis of lung cancer (n=51). All participants provided demographic and medical information and completed measures of hope, lung cancer symptoms, and psychological distress. RESULTS: Data analyses found that hope was inversely associated with major symptoms of cancer (i.e., pain, fatigue, and cough) and psychological distress (i.e., depression), even after accounting for important demographic and medical variables (i.e., age and cancer stage). CONCLUSION: The findings of this cross-sectional study highlight the potential importance of hope in understanding adjustment to lung cancer. Future longitudinal research could help reveal how hope and adjustment interact over the course of cancer survivorship.

Authors
Berendes, D; Keefe, FJ; Somers, TJ; Kothadia, SM; Porter, LS; Cheavens, JS
MLA Citation
Berendes, D, Keefe, FJ, Somers, TJ, Kothadia, SM, Porter, LS, and Cheavens, JS. "Hope in the context of lung cancer: relationships of hope to symptoms and psychological distress." J Pain Symptom Manage 40.2 (August 2010): 174-182.
PMID
20579840
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
40
Issue
2
Publish Date
2010
Start Page
174
End Page
182
DOI
10.1016/j.jpainsymman.2010.01.014

Understanding and enhancing patient and partner adjustment to disease-related pain: A biopsychosocial perspective

Persistent, disease-related pain is a challenge not only for patients who experience it, but also for their loved ones. There is growing interest in involving partners and caregivers in pain management efforts. The purpose of this chapter is to discuss factors that influence patient and partner adjustment to diseaserelated pain within a biopsychosocial framework and provide an overview of biopsychosocial approaches involving partners in pain management. The chapter is divided into three sections. In the first section, we present a biopsychosocial model that can be used to understand how patients and their partners adjust to disease-related pain. In the second section, we discuss factors that influence patient and partner adjustment to both arthritis pain and cancer pain and how these factors are influenced by patient and partner pain management interventions. Finally, we highlight important future directions for clinical and research efforts in this area.

Authors
Somers, TJ; Keefe, FJ; Porter, L
MLA Citation
Somers, TJ, Keefe, FJ, and Porter, L. "Understanding and enhancing patient and partner adjustment to disease-related pain: A biopsychosocial perspective." (December 1, 2009): 95-124. (Chapter)
Source
scopus
Publish Date
2009
Start Page
95
End Page
124
DOI
10.1007/978-0-387-78323-9_6

Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial.

GOAL OF WORK: Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB). MATERIALS AND METHODS: Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. MAIN RESULTS: At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. CONCLUSIONS: This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.

Authors
Carson, JW; Carson, KM; Porter, LS; Keefe, FJ; Seewaldt, VL
MLA Citation
Carson, JW, Carson, KM, Porter, LS, Keefe, FJ, and Seewaldt, VL. "Yoga of Awareness program for menopausal symptoms in breast cancer survivors: results from a randomized trial." Support Care Cancer 17.10 (October 2009): 1301-1309.
PMID
19214594
Source
pubmed
Published In
Supportive Care in Cancer
Volume
17
Issue
10
Publish Date
2009
Start Page
1301
End Page
1309
DOI
10.1007/s00520-009-0587-5

Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized controlled trial.

BACKGROUND: For patients with cancer who are married or in an intimate relationship, their relationships with their partners play a critical role in their adaptation to illness. However, cancer patients and their partners often have difficulty in talking with each other about their cancer-related concerns. Difficulties in communication ultimately may compromise both the patient-partner relationship and the patient's psychological adjustment. The current study tested the efficacy of a novel partner-assisted emotional disclosure intervention in a sample of patients with gastrointestinal (GI) cancer. METHODS: One hundred thirty patients with GI cancer and their partners were assigned randomly to receive 4 sessions of either partner-assisted emotional disclosure or a couples cancer education/support intervention. Patients and partners completed measures of relationship quality, intimacy with their partner, and psychological distress before randomization and at the end of the intervention sessions. Data were analyzed using multilevel modeling. RESULTS: Compared with an education/support condition, the partner-assisted emotional disclosure condition led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. CONCLUSIONS: Partner-assisted emotional disclosure is a novel intervention that builds on both the private emotional disclosure and the cognitive-behavioral marital literature. The results of this study suggested that this intervention may be beneficial for couples in which the patient tends to hold back from discussing concerns. The authors concluded that future research on methods of enhancing the effects of partner-assisted emotional disclosure is warranted.

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Hurwitz, H; Moser, B; Patterson, E; Kim, HJ
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Hurwitz, H, Moser, B, Patterson, E, and Kim, HJ. "Partner-assisted emotional disclosure for patients with gastrointestinal cancer: results from a randomized controlled trial." Cancer 115.18 Suppl (September 15, 2009): 4326-4338.
PMID
19731357
Source
pubmed
Published In
Cancer
Volume
115
Issue
18 Suppl
Publish Date
2009
Start Page
4326
End Page
4338
DOI
10.1002/cncr.24578

Initial report of the cancer Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function committee: review of sexual function measures and domains used in oncology.

For this report, the authors described the initial activities of the Cancer Patient-Reported Outcomes Measurement Information System (PROMIS)-Sexual Function domain group, which is part of the National Institutes of Health Roadmap Initiative to develop brief questionnaires or individually tailored assessments of quality-of-life domains. Presented are a literature review of sexual function measures used in cancer populations and descriptions of the domains found in those measures. By using a consensus-driven approach, an electronic bibliographic search was conducted for articles that were published from 1991 to 2007, and 486 articles were identified for in-depth review. In total, 257 articles reported the administration of a psychometrically evaluated sexual function measure to individuals who were diagnosed with cancer. Apart from the University of California-Los Angeles Prostate Cancer Index, the International Index of Erectile Function, and the Female Sexual Function Index, the 31 identified measures have not been tested widely in cancer populations. Most measures were multidimensional and included domains related to the sexual response cycle and to general sexual satisfaction. The current review supports the need for a flexible, psychometrically robust measure of sexual function for use in oncology settings and strongly justifies the development of the PROMIS-Sexual Function instrument. When the PROMIS-Sexual Function instrument is available publicly, cancer clinicians and researchers will have another measure with which to assess patient-reported sexual function outcomes in addition to the few legacy measures that were identified through this review.

Authors
Jeffery, DD; Tzeng, JP; Keefe, FJ; Porter, LS; Hahn, EA; Flynn, KE; Reeve, BB; Weinfurt, KP
MLA Citation
Jeffery, DD, Tzeng, JP, Keefe, FJ, Porter, LS, Hahn, EA, Flynn, KE, Reeve, BB, and Weinfurt, KP. "Initial report of the cancer Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function committee: review of sexual function measures and domains used in oncology." Cancer 115.6 (March 15, 2009): 1142-1153. (Review)
PMID
19195044
Source
pubmed
Published In
Cancer
Volume
115
Issue
6
Publish Date
2009
Start Page
1142
End Page
1153
DOI
10.1002/cncr.24134

A couple-based intervention for female breast cancer

Objective: Although women's breast cancer affects both women and their male partners, as well as their relationships, few interventions have been developed to work with couples confronting breast cancer. The current investigation presents the pilot results from a new couple-based intervention program for breast cancer that teaches couples how to minimize negative effects and maximize positive functioning during this diffcult time. Method: In this pilot study, 14 couples in which the wife had early stage breast cancer were randomly assigned to one of the two treatment conditions: Couple-based relationship enhancement (RE) or treatment-as-usual (TAU). Results: The results from this study suggest that compared with couples receiving treatment-as-usual, both women and men in the RE condition experienced improved functioning on individual psychological variables as well as relationship functioning at posttest and 1-year follow-up. In addition, women in RE show fewer medical symptoms at both time periods. Conclusions: In this pilot study, the couple-based intervention, RE, has shown promise in improving individual, medical, and relationship functioning for couples in which the woman is facing breast cancer, and therefore merits further investigation on a larger scale. Copyright © 2008 John Wiley & Sons, Ltd.

Authors
Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Wiesenthal, N; Aldridge, W; Fredman, SJ; Stanton, SE; Scott, JL; Halford, KW; Keefe, FJ
MLA Citation
Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, Wiesenthal, N, Aldridge, W, Fredman, SJ, Stanton, SE, Scott, JL, Halford, KW, and Keefe, FJ. "A couple-based intervention for female breast cancer." Psycho-Oncology 18.3 (2009): 276-283.
PMID
18702064
Source
scival
Published In
Psycho-Oncology
Volume
18
Issue
3
Publish Date
2009
Start Page
276
End Page
283
DOI
10.1002/pon.1395

Quantifying the recruitment challenges with couple-based interventions for cancer: Applications to early-stage breast cancer

Objective: Despite mounting evidence supporting the use of psychosocial interventions to promote adaptation to cancer, enrolling participants into these interventions is challenging. This is particularly salient for couple-based interventions, and newer, more targeted recruitment strategies to increase enrollment are needed. However, there have been few published empirical studies focused specifically on recruitment-related variables associated with enrollment into these types of interventions. To better understand how to encourage participation in couple-based psychosocial interventions for cancer, we examined facilitating and impeding factors to enrollment into a couple-based intervention for women with early-stage breast cancer. Method: In this sample of 99 women diagnosed with early-stage breast cancer, patient demographic variables and method of approaching eligible patients were examined as predictors of enrollment into a randomized controlled trial comparing couple-based relationship enhancement with treatment as usual. Results: Results indicated that women were more likely to enroll if they were contacted at home or at a follow-up medical appointment rather than when first diagnosed at a busy multidisciplinary clinic; they were also more likely to enroll the closer they lived to the research facility. Conclusions: In addition to decreasing participant burden, timing and setting of recruitment efforts may have important implications for enhancing participation rates in couple-based intervention studies for cancer. Copyright © 2008 John Wiley & Sons, Ltd.

Authors
Fredman, SJ; Baucom, DH; Gremore, TM; Castellani, AM; Kallman, TA; Porter, LS; Kirby, JS; Dees, EC; Klauber-Demore, N; Peppercom, J; Carey, LA
MLA Citation
Fredman, SJ, Baucom, DH, Gremore, TM, Castellani, AM, Kallman, TA, Porter, LS, Kirby, JS, Dees, EC, Klauber-Demore, N, Peppercom, J, and Carey, LA. "Quantifying the recruitment challenges with couple-based interventions for cancer: Applications to early-stage breast cancer." Psycho-Oncology 18.6 (2009): 667-673.
PMID
19061201
Source
scival
Published In
Psycho-Oncology
Volume
18
Issue
6
Publish Date
2009
Start Page
667
End Page
673
DOI
10.1002/pon.1477

Pain communication in the context of osteoarthritis: patient and partner self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns.

OBJECTIVES: This preliminary study examined aspects of pain communication (self-efficacy for pain communication and holding back from discussing pain and arthritis-related concerns) among patients with osteoarthritis (OA) and their partners, and associations between patient and partner pain communication and measures of patient and partner adjustment. METHODS: A sample of 38 patients with OA and their partners completed measures of self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns. Patients completed measures of pain, physical and psychologic disability, and pain catastrophizing, and partners completed measures of caregiver strain and positive and negative affect. RESULTS: Correlation analyses indicated that, among patients, higher levels of self-efficacy for pain communication were associated with significantly lower levels of pain, physical and psychologic disability, and pain catastrophizing, and with lower levels of partner negative affect. Among partners, high self-efficacy for pain communication was associated with higher levels of positive affect. Among patients, higher levels of holding back were significantly correlated with higher levels of psychologic disability and catastrophizing. Higher levels of partner holding back were associated with significantly higher levels of caregiver strain, and with higher levels of patient psychologic disability and catastrophizing. DISCUSSION: Taken together, results from this preliminary study suggest that self-efficacy for pain communication and holding back from discussions of pain and arthritis-related concerns may be important in understanding how patients with OA and their partners adjust to the demands of the patient's disease.

Authors
Porter, LS; Keefe, FJ; Wellington, C; de Williams, A
MLA Citation
Porter, LS, Keefe, FJ, Wellington, C, and de Williams, A. "Pain communication in the context of osteoarthritis: patient and partner self-efficacy for pain communication and holding back from discussion of pain and arthritis-related concerns." Clin J Pain 24.8 (October 2008): 662-668.
PMID
18806530
Source
pubmed
Published In
Clinical Journal of Pain
Volume
24
Issue
8
Publish Date
2008
Start Page
662
End Page
668
DOI
10.1097/AJP.0b013e31816ed964

Spouse disclosure of cancer-related concerns: Associations with spouse and patient adjustment

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Hurwitz, H; Bendell, J
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Hurwitz, H, and Bendell, J. "Spouse disclosure of cancer-related concerns: Associations with spouse and patient adjustment." ANNALS OF BEHAVIORAL MEDICINE 35 (March 2008): S171-S171.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
35
Publish Date
2008
Start Page
S171
End Page
S171

Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress

This study examined self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their caregivers, and associations between self-efficacy and patient and caregiver adjustment. One hundred and fifty-two patients with early stage lung cancer completed measures of self-efficacy, pain, fatigue, quality of life, depression, and anxiety. Their caregivers completed a measure assessing their self-efficacy for helping the patient manage symptoms and measures of psychological distress and caregiver strain. Analyses indicated that, overall, patients and caregivers were relatively low in self-efficacy for managing pain, symptoms, and function, and that there were significant associations between self-efficacy and adjustment. Patients low in self-efficacy reported significantly higher levels of pain, fatigue, lung cancer symptoms, depression, and anxiety, and significantly worse physical and functional well being, as did patients whose caregivers were low in self-efficacy. When patients and caregivers both had low self-efficacy, patients reported higher levels of anxiety and poorer quality of life than when both were high in self-efficacy. There were also significant associations between patient and caregiver self-efficacy and caregiver adjustment, with lower levels of self-efficacy associated with higher levels of caregiver strain and psychological distress. These preliminary findings raise the possibility that patient and caregiver self-efficacy for managing pain, symptoms, and function may be important factors affecting adjustment, and that interventions targeted at increasing self-efficacy may be useful in this population. © 2007 International Association for the Study of Pain.

Authors
Porter, LS; Keefe, FJ; Garst, J; McBride, CM; Baucom, D
MLA Citation
Porter, LS, Keefe, FJ, Garst, J, McBride, CM, and Baucom, D. "Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: Associations with symptoms and distress." Pain 137.2 (2008): 306-315.
PMID
17942229
Source
scival
Published In
PAIN
Volume
137
Issue
2
Publish Date
2008
Start Page
306
End Page
315
DOI
10.1016/j.pain.2007.09.010

Body image and sexual functioning among women with early stage breast cancer: The impact of a couple-based intervention program

Authors
Baucom, DH; Dyo, S; Porter, LS; Kirby, JS; Gremore, TM; Pukay-Martin, N; Keefe, FJ
MLA Citation
Baucom, DH, Dyo, S, Porter, LS, Kirby, JS, Gremore, TM, Pukay-Martin, N, and Keefe, FJ. "Body image and sexual functioning among women with early stage breast cancer: The impact of a couple-based intervention program." INTERNATIONAL JOURNAL OF PSYCHOLOGY 43.3-4 (2008): 40-40.
Source
wos-lite
Published In
International Journal of Psychology
Volume
43
Issue
3-4
Publish Date
2008
Start Page
40
End Page
40

YOGA FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS FROM A PILOT STUDY

Authors
Carson, JW; Carson, KM; Porter, LS; Keefe, FJ; Shaw, H
MLA Citation
Carson, JW, Carson, KM, Porter, LS, Keefe, FJ, and Shaw, H. "YOGA FOR WOMEN WITH METASTATIC BREAST CANCER: RESULTS FROM A PILOT STUDY." ANNALS OF BEHAVIORAL MEDICINE 33 (December 2007): S30-S30.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
33
Publish Date
2007
Start Page
S30
End Page
S30

GENDER DIFFERENCES IN CORRELATES OF GI CANCER PATIENTS' DISCLOSURE TO THEIR SPOUSES

Authors
Porter, LS; Keefe, FJ; Baucom, DH; Hurwitz, H; Bendell, J
MLA Citation
Porter, LS, Keefe, FJ, Baucom, DH, Hurwitz, H, and Bendell, J. "GENDER DIFFERENCES IN CORRELATES OF GI CANCER PATIENTS' DISCLOSURE TO THEIR SPOUSES." ANNALS OF BEHAVIORAL MEDICINE 33 (December 2007): S27-S27.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
33
Publish Date
2007
Start Page
S27
End Page
S27

WHAT ASPECTS OF MARITAL FUNCTIONING ARE IMPORTANT IN ADJUSTMENT TO BREAST CANCER?

Authors
Porter, LS; Baucom, D; Keefe, F; Gremore, T; Kirby, J; Marcom, PK
MLA Citation
Porter, LS, Baucom, D, Keefe, F, Gremore, T, Kirby, J, and Marcom, PK. "WHAT ASPECTS OF MARITAL FUNCTIONING ARE IMPORTANT IN ADJUSTMENT TO BREAST CANCER?." ANNALS OF BEHAVIORAL MEDICINE 33 (December 2007): S141-S141.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
33
Publish Date
2007
Start Page
S141
End Page
S141

RELAXATION PREDICTS SUBSEQUENT HOT FLASHES IN WOMEN AT HIGH RISK FOR BREAST CANCER

Authors
Carson, JW; Porter, LS
MLA Citation
Carson, JW, and Porter, LS. "RELAXATION PREDICTS SUBSEQUENT HOT FLASHES IN WOMEN AT HIGH RISK FOR BREAST CANCER." ANNALS OF BEHAVIORAL MEDICINE 33 (December 2007): S141-S141.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
33
Publish Date
2007
Start Page
S141
End Page
S141

The sexual function domain of the NIHPROMIS: Preliminary report

Authors
Jeffery, DD; Reeve, BB; Tzeng, J; Weinfurt, KP; Flynn, KE; Keefe, FJ; Porter, LS; Hahn, EA; Cella, D
MLA Citation
Jeffery, DD, Reeve, BB, Tzeng, J, Weinfurt, KP, Flynn, KE, Keefe, FJ, Porter, LS, Hahn, EA, and Cella, D. "The sexual function domain of the NIHPROMIS: Preliminary report." PSYCHO-ONCOLOGY 16.9 (September 2007): S233-S233.
Source
wos-lite
Published In
Psycho-Oncology
Volume
16
Issue
9
Publish Date
2007
Start Page
S233
End Page
S233

Conflict about expressing emotions and chronic low back pain: associations with pain and anger.

UNLABELLED: There has been growing interest among researchers and clinicians in the role of ambivalence over emotional expression (AEE) in adjustment to chronic illness. Because of the salience of anger in chronic low back pain, this condition provides a particularly good model in which to examine the role of AEE. This study examined the relation of AEE to pain and anger in a sample of 61 patients with chronic low back pain. Patients completed standardized measures of AEE, pain, and anger. Correlational analyses showed that patients who had higher AEE scores reported higher levels of evaluative and affective pain as well as higher levels of state and trait anger and the tendency to hold in angry thoughts and feelings. Mediational analyses revealed that most of the associations between AEE and pain, and AEE and anger, were independent of one another. These findings suggest that a potentially important relationship exists between AEE and key aspects of living with persistent pain. PERSPECTIVE: This preliminary study suggests that there is a relation between ambivalence over emotional expression and pain and anger in patients with chronic low back pain. Patients who report greater conflict with regard to expressing emotions may be experiencing higher pain and anger.

Authors
Carson, JW; Keefe, FJ; Lowry, KP; Porter, LS; Goli, V; Fras, AM
MLA Citation
Carson, JW, Keefe, FJ, Lowry, KP, Porter, LS, Goli, V, and Fras, AM. "Conflict about expressing emotions and chronic low back pain: associations with pain and anger." J Pain 8.5 (May 2007): 405-411.
PMID
17276143
Source
pubmed
Published In
The Journal of Pain
Volume
8
Issue
5
Publish Date
2007
Start Page
405
End Page
411
DOI
10.1016/j.jpain.2006.11.004

Attachment and pain: recent findings and future directions.

Authors
Porter, LS; Davis, D; Keefe, FJ
MLA Citation
Porter, LS, Davis, D, and Keefe, FJ. "Attachment and pain: recent findings and future directions." Pain 128.3 (April 2007): 195-198. (Review)
PMID
17321050
Source
pubmed
Published In
Pain
Volume
128
Issue
3
Publish Date
2007
Start Page
195
End Page
198
DOI
10.1016/j.pain.2007.02.001

Yoga for women with metastatic breast cancer: results from a pilot study.

Metastatic breast cancer (MBC) remains a terminal illness for which major treatment advances are slow to appear, and hence it is crucial that effective palliative interventions be developed to reduce the cancer-related symptoms of women with this condition during the remaining years of their lives. This pilot/feasibility study examined a novel, yoga-based palliative intervention, the Yoga of Awareness Program, in a sample of women with MBC. The eight-week protocol included gentle yoga postures, breathing exercises, meditation, didactic presentations, and group interchange. Outcome was assessed using daily measures of pain, fatigue, distress, invigoration, acceptance, and relaxation during two preintervention weeks and the final two weeks of the intervention. Thirteen women completed the intervention (mean age=59; mean time since diagnosis=7 years; two African American, 11 Caucasian). During the study, four participants had cancer recurrences, and the physical condition of several others deteriorated noticeably. Despite low statistical power, pre-to-post multilevel outcomes analyses showed significant increases in invigoration and acceptance. Lagged analyses of length of home yoga practice (controlling for individual mean practice time and outcome levels on the lagged days) showed that on the day after a day during which women practiced more, they experienced significantly lower levels of pain and fatigue, and higher levels of invigoration, acceptance, and relaxation. These findings support the need for further investigation of the effects of the Yoga of Awareness Program in women with MBC.

Authors
Carson, JW; Carson, KM; Porter, LS; Keefe, FJ; Shaw, H; Miller, JM
MLA Citation
Carson, JW, Carson, KM, Porter, LS, Keefe, FJ, Shaw, H, and Miller, JM. "Yoga for women with metastatic breast cancer: results from a pilot study." J Pain Symptom Manage 33.3 (March 2007): 331-341.
PMID
17349503
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
33
Issue
3
Publish Date
2007
Start Page
331
End Page
341
DOI
10.1016/j.jpainsymman.2006.08.009

Pain catastrophizing in the context of satisfaction with spousal responses: New perspectives and new opportunities

Authors
Keefe, FJ; Porter, L
MLA Citation
Keefe, FJ, and Porter, L. "Pain catastrophizing in the context of satisfaction with spousal responses: New perspectives and new opportunities." Pain 131.1-2 (2007): 1-2.
PMID
17590516
Source
scival
Published In
PAIN
Volume
131
Issue
1-2
Publish Date
2007
Start Page
1
End Page
2
DOI
10.1016/j.pain.2007.05.016

Predicting negative mood state and personal growth in African American and White long-term breast cancer survivors.

BACKGROUND: Relatively little research has examined cognitive processes that may impact psychological adaptation in older long-term breast cancer survivors (BCS). PURPOSE: This study investigated the strength of a conceptual model based on the literature and Uncertainty in Illness Theories which proposes that negative mood state and personal growth in older long-term White and African American BCS would be predicted by the combined influences of demographic and disease variables, social support, religious participation, and cognitive processes (uncertainty, catastrophizing, troublesome thoughts, and cognitive reframing). METHODS: Baseline data were gathered from 524 BCS (369 Whites and 155 African Americans, 5-9 years postdiagnosis) prior to their participating in an uncertainty management intervention program. The conceptual model was tested using structural equation modeling. RESULTS: The multigroup model showed good fit to the data and explained substantial variance in negative mood state and personal growth. Cognitive processes showed both direct and indirect effects on outcomes in the expected directions. Several ethnic differences were found: African Americans were more negatively affected by comorbidities and Whites by symptom distress, whereas cognitive reframing was a stronger predictor of personal growth for African Americans than Whites. CONCLUSIONS: This is one of the first studies to explore predictors of both negative mood and personal growth in a multiethnic sample of BCS. These findings suggest that cognitive processes play an important role in psychological adaptation to breast cancer survivorship. These processes are amenable to change, suggesting a logical target for intervention with this population.

Authors
Porter, LS; Clayton, MF; Belyea, M; Mishel, M; Gil, KM; Germino, BB
MLA Citation
Porter, LS, Clayton, MF, Belyea, M, Mishel, M, Gil, KM, and Germino, BB. "Predicting negative mood state and personal growth in African American and White long-term breast cancer survivors." Ann Behav Med 31.3 (June 2006): 195-204.
PMID
16700633
Source
pubmed
Published In
Annals of Behavioral Medicine
Volume
31
Issue
3
Publish Date
2006
Start Page
195
End Page
204
DOI
10.1207/s15324796abm3103_1

Benefits of the uncertainty management intervention for African American and white older breast cancer survivors: 20-Month outcomes

In a 2 x 2 randomized block repeated measure design, this study evaluated the follow-up efficacy of the uncertainty management intervention at 20 months. The sample included 483 recurrence-free women (342 White, 141 African American women; mean age = 64 years) who were 5-9 years posttreatment for breast cancer. Women were randomly assigned to either the intervention or usual care control condition. The intervention was delivered during 4 weekly telephone sessions in which survivors were guided in the use of audiotaped cognitive-behavioral strategies and a self-help manual. Repeated measures MANOVAs evaluating treatment group, ethnic group, and treatment by ethnic interaction effects at 20 months indicated that training in uncertainty management resulted in improvements in cognitive reframing, cancer knowledge, and a variety of coping skills. Importantly, the 20-month outcomes also demonstrated benefits for women in the intervention condition in terms of declines in illness uncertainty and stable effects in personal growth over time. Copyright © 2006 by Lawrence Erlbaum Associates, Inc.

Authors
Gil, KM; Mishel, MH; Belyea, M; Germino, B; Porter, LS; Clayton, M
MLA Citation
Gil, KM, Mishel, MH, Belyea, M, Germino, B, Porter, LS, and Clayton, M. "Benefits of the uncertainty management intervention for African American and white older breast cancer survivors: 20-Month outcomes." International Journal of Behavioral Medicine 13.4 (2006): 286-294.
PMID
17228986
Source
scival
Published In
International Journal of Behavioral Medicine
Volume
13
Issue
4
Publish Date
2006
Start Page
286
End Page
294
DOI
10.1207/s15327558ijbm1304_3

Relationship of dysfunctional sleep-related thoughts and behaviors, pre-sleep arousal, cancer symptoms, and mood to sleep in breast and lung cancer patients with insomnia

Authors
Rumble, M; Keefe, FJ; Edinger, JD; Porter, LS; Garst, JL; Marcom, PK
MLA Citation
Rumble, M, Keefe, FJ, Edinger, JD, Porter, LS, Garst, JL, and Marcom, PK. "Relationship of dysfunctional sleep-related thoughts and behaviors, pre-sleep arousal, cancer symptoms, and mood to sleep in breast and lung cancer patients with insomnia." 2006.
Source
wos-lite
Published In
Sleep
Volume
29
Publish Date
2006
Start Page
A251
End Page
A251

Disclosure between patients with gastrointestinal cancer and their spouses.

This study examined patterns of disclosure about cancer-related concerns between patients with GI cancer and their spouses, and associations between patient and spouse disclosure and patient adjustment, spouse adjustment, and aspects of relationship functioning. A sample of 47 patients and 45 of their spouses completed a measure of disclosure which included ratings of their level of disclosure and level of holding back from disclosure of cancer-related concerns. Patients completed a measure of quality of life, spouses completed a measure of caregiver strain, and all participants completed measures of psychological distress and relationship functioning (intimacy, empathy, and partner avoidance and criticism). Data analyses revealed that patients and spouses reported moderately high levels of disclosure and low levels of holding back, with patients reporting higher levels of disclosure than spouses. Among patients and spouses, low levels of disclosure and high levels of holding back were associated with poorer relationship functioning. There were also some indications that high levels of holding back, and to a lesser extent low levels of disclosure, were associated with increased psychological distress for both patients and spouses. However, there were no indications that patient or spouse disclosure was harmful for the other person. Considered overall, the results of this study suggest that levels of disclosure between cancer patients and their spouses may be important in understanding how they adjust as a couple to the demands of the patient's illness.

Authors
Porter, LS; Keefe, FJ; Hurwitz, H; Faber, M
MLA Citation
Porter, LS, Keefe, FJ, Hurwitz, H, and Faber, M. "Disclosure between patients with gastrointestinal cancer and their spouses." Psychooncology 14.12 (December 2005): 1030-1042.
PMID
15712247
Source
pubmed
Published In
Psycho-Oncology
Volume
14
Issue
12
Publish Date
2005
Start Page
1030
End Page
1042
DOI
10.1002/pon.915

Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life.

This study examined the role of patient and caregiver ambivalence over emotional expression (AEE) in pain and quality of life (QOL) in a sample of 78 patients with gastrointestinal (GI) cancer. Measures of ambivalence over emotional expression as well as ratings of patient pain and pain behavior were collected from patients and caregivers. Measures of pain catastrophizing, perceptions of social support, and QOL were obtained from patients. Data analyses revealed that patients high in AEE engaged in more catastrophizing and reported higher levels of pain behaviors and poorer QOL. In addition, patients whose caregivers were high in AEE engaged in more catastrophizing, had higher levels of pain and pain behavior, and reported lower emotional well-being. Patient catastrophizing mediated the effects of both patient and caregiver AEE on some patient outcomes. Taken together, these findings suggest that emotional regulation in both patients and their caregivers may be an important factor in understanding cancer patients' experience of and coping with symptoms such as pain.

Authors
Porter, LS; Keefe, FJ; Lipkus, I; Hurwitz, H
MLA Citation
Porter, LS, Keefe, FJ, Lipkus, I, and Hurwitz, H. "Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life." Pain 117.3 (October 2005): 340-348.
PMID
16153771
Source
pubmed
Published In
PAIN
Volume
117
Issue
3
Publish Date
2005
Start Page
340
End Page
348
DOI
10.1016/j.pain.2005.06.021

A pilot study investigating the utility of the cognitive-behavioral model of insomnia in early-stage lung cancer patients.

This pilot study investigated the utility of a cognitive-behavioral model in understanding insomnia in early-stage lung cancer patients. Nineteen patients meeting criteria for insomnia and a comparison group of 13 patients not meeting these criteria completed questionnaires assessing dysfunctional sleep-related thoughts, poor sleep hygiene, lung cancer symptoms, mood, quality of life, and insomnia symptoms. Participants also completed standard sleep logs and wore an Actiwatch while sleeping each day for 7 days. Findings indicated that the insomnia group reported significantly more dysfunctional sleep-related thoughts, higher levels of pain and anxiety, and lower quality of life than those in the comparison group. Men in the insomnia group reported significantly higher levels of fatigue than men in the comparison group, whereas women demonstrated no group differences. These pilot findings support the utility of the cognitive-behavioral model in understanding insomnia in early-stage lung cancer patients and the hypothesis that insomnia is related to poor clinical status.

Authors
Rumble, ME; Keefe, FJ; Edinger, JD; Porter, LS; Garst, JL
MLA Citation
Rumble, ME, Keefe, FJ, Edinger, JD, Porter, LS, and Garst, JL. "A pilot study investigating the utility of the cognitive-behavioral model of insomnia in early-stage lung cancer patients." J Pain Symptom Manage 30.2 (August 2005): 160-169.
PMID
16125031
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
30
Issue
2
Publish Date
2005
Start Page
160
End Page
169
DOI
10.1016/j.jpainsymman.2005.02.013

Psychosocial issues confronting young women with breast cancer

The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychological distress including depression and anxiety. Within the relationship, emotional support from the partner is important in women's adjustment. In terms of psychosocial interventions for breast cancer, findings suggest that the most frequently employed interventions, which treat the woman without her partner, are not optimal. Initial findings provide encouraging evidence that couple-based psychosocial interventions for women and their partners might be of particular assistance to both partners. © 2005,2006 IOS Press. All rights reserved.

Authors
Baucom, DH; Porter, LS; Kirby, JS; Gremore, TM; Keefe, FJ
MLA Citation
Baucom, DH, Porter, LS, Kirby, JS, Gremore, TM, and Keefe, FJ. "Psychosocial issues confronting young women with breast cancer." Breast Disease 23 (2005): 103-113.
PMID
16823173
Source
scival
Published In
Breast Disease
Volume
23
Publish Date
2005
Start Page
103
End Page
113

Benefits from an uncertainty management intervention for African-American and Caucasian older long-term breast cancer survivors

In a randomized controlled design, this study tested the efficacy of a theoretically based uncertainty management intervention delivered to older long-term breast cancer survivors. The sample included 509 recurrence-free women (360 Caucasian, 149 African-American women) with a mean age of 64 years (S.D. = 8.9 years) who were 5-9 years post-treated for breast cancer. Women were randomly assigned to either the intervention or usual care control condition. The intervention was delivered during four weekly telephone sessions, in which study nurses guided cancer survivors in the use of audiotaped cognitive-behavioral strategies to manage uncertainty about recurrence, and a self-help manual designed to help women understand and manage long-term treatment side effects and other symptoms. Treatment outcome data on uncertainty management were gathered at pre-intervention and 10-months afterward. Repeated measures MANOVA evaluating treatment group, ethnic group, and treatment by ethnic interaction effects indicated that training in uncertainty management resulted in improvements in cognitive reframing, cancer knowledge, patient-health care provider communication, and a variety of coping skills. Results are discussed in terms of the importance of theory-based interventions for cancer survivors that target triggers of uncertainty about recurrence and in terms of ethnic differences in response to the intervention. Copyright © 2005 John Wiley & Sons, Ltd.

Authors
Mishel, MH; Germino, BB; Gil, KM; Belyea, M; Laney, IC; Stewart, J; Porter, L; Clayton, M
MLA Citation
Mishel, MH, Germino, BB, Gil, KM, Belyea, M, Laney, IC, Stewart, J, Porter, L, and Clayton, M. "Benefits from an uncertainty management intervention for African-American and Caucasian older long-term breast cancer survivors." Psycho-Oncology 14.11 (2005): 962-978.
PMID
15712339
Source
scival
Published In
Psycho-Oncology
Volume
14
Issue
11
Publish Date
2005
Start Page
962
End Page
978
DOI
10.1002/pon.909

Uncertainty management intervention for older African American and Caucasian long-term breast cancer survivors

The survivor uncertainty management intervention study is a randomized controlled study designed to test the efficacy of an intervention that combines training in audiotaped cognitive behavioral strategies to manage uncertainty about cancer recurrence with a self-help manual designed to help women understand and manage long-term treatment side effects and other symptoms. Specifically, women were taught to recognize their own personal triggers of uncertainty (places, events or surroundings, that bring back memories, feelings, or concerns about breast cancer), and then use coping skills such as relaxation, distraction, and calming self-talk to deal with uncertainty. Also, women were taught to use the manual as a resource for dealing with fatigue, lymphedema, pain and other symptoms. Treatment outcome data (Mishel et al., in press) indicated that the uncertainty management intervention resulted in improvements in cognitive reframing, cancer knowledge, social support, knowledge of symptoms and side effects, and coping skills when compared to a control condition. The purpose of the present paper was to report on the use and helpfulness of the intervention components by the 244 women who were in the intervention. Findings indicated that women regularly used the intervention components to deal with triggers of breast cancer recurrence and long-term treatment side effects and most women found the strategies very helpful. © 2005 by The Haworth Press, Inc. All rights reserved.

Authors
Gil, KM; Mishel, MH; Germino, B; Porter, LS; Carlton-LaNey, I; Belyea, M
MLA Citation
Gil, KM, Mishel, MH, Germino, B, Porter, LS, Carlton-LaNey, I, and Belyea, M. "Uncertainty management intervention for older African American and Caucasian long-term breast cancer survivors." Journal of Psychosocial Oncology 23.2-3 (2005): 3-21.
PMID
16492649
Source
scival
Published In
Journal of Psychosocial Oncology
Volume
23
Issue
2-3
Publish Date
2005
Start Page
3
End Page
21
DOI
10.1300/J077v23n02_02

A pilot study examining the utility of the cognitive-behavioral model of insomnia in early stage breast cancer patients

Authors
Rumble, M; Edinger, JD; Keefe, FJ; Porter, LS; Marcom, PK
MLA Citation
Rumble, M, Edinger, JD, Keefe, FJ, Porter, LS, and Marcom, PK. "A pilot study examining the utility of the cognitive-behavioral model of insomnia in early stage breast cancer patients." 2005.
Source
wos-lite
Published In
Sleep
Volume
28
Publish Date
2005
Start Page
A228
End Page
A228

Predicting the intentions of women in domestic violence shelters to return to partners: Does forgiveness play a role?

Recent findings indicate that college women's forgiveness of hypothetical dating violence was predictive of their hypothetical decisions to stay in the relationship. This study was designed to evaluate the role of forgiveness in women's intentions to return to their partners from a domestic violence shelter. A sample of 121 women residing in both urban and rural domestic violence shelters filled out a series of questionnaires evaluating demographic information, severity of violence, attributions for violence, psychological constraints (or investment), and forgiveness of the partner. Forgiveness was found to predict intention to return to partner over and above the other variables studied. These findings suggest that the degree to which women are willing to "move on" from the abuse and to let go of their anger toward their partners may play a significant role in their intention to remain in a relationship with their partners.

Authors
Gordon, KC; Burton, S; Porter, L
MLA Citation
Gordon, KC, Burton, S, and Porter, L. "Predicting the intentions of women in domestic violence shelters to return to partners: Does forgiveness play a role?." Journal of Family Psychology 18.2 (2004): 331-338.
PMID
15222840
Source
scival
Published In
Journal of Family Psychology
Volume
18
Issue
2
Publish Date
2004
Start Page
331
End Page
338
DOI
10.1037/0893-3200.18.2.331

Daily Mood and Stress Predict Pain, Health Care Use, and Work Activity in African American Adults with Sickle-Cell Disease

This study examined the extent to which daily mood and stress were associated with pain, health care use, and work activity in 41 adults (mean age = 36 years) with sickle-cell disease. Multilevel model analyses of daily diaries (M = 91 days) indicated that increases in stress and negative mood were associated with increases in same-day pain, health care use, and work absences. Lagged models suggested bidirectional relationships, with evidence that pain may be the more powerful initiating variable in pain-mood and pain-stress cycles. Of importance, positive mood was associated with lower same-day and subsequent-day pain, as well as fewer health care contacts, suggesting that positive mood may serve to offset negative consequences of pain and other illness symptoms.

Authors
Gil, KM; Carson, JW; Porter, LS; Scipio, C; Bediako, SM; Orringer, E
MLA Citation
Gil, KM, Carson, JW, Porter, LS, Scipio, C, Bediako, SM, and Orringer, E. "Daily Mood and Stress Predict Pain, Health Care Use, and Work Activity in African American Adults with Sickle-Cell Disease." Health Psychology 23.3 (2004): 267-274.
PMID
15099167
Source
scival
Published In
Health Psychology
Volume
23
Issue
3
Publish Date
2004
Start Page
267
End Page
274
DOI
10.1037/0278-6133.23.3.267

Triggers of uncertainty about recurrence and long-term treatment side effects in older African American and Caucasian breast cancer survivors.

PURPOSE/OBJECTIVES: To examine the sources of uncertainty in older African American and Caucasian long-term breast cancer survivors by focusing on frequency of triggers of uncertainty about cancer recurrence and physical symptoms linked to long-term treatment side effects. DESIGN: In the context of a larger randomized, controlled treatment-outcome study, data were gathered from 10 monthly follow-up telephone calls by nurses. SETTING: Rural and urban regions of North Carolina. SAMPLE: 244 older women (mean age = 64 years); 73 African American women and 171 Caucasian women who were five to nine years after breast cancer diagnosis. FINDINGS: The most frequent triggers were hearing about someone else's cancer and new aches and pains. The most frequent symptoms were fatigue, joint stiffness, and pain. Although no ethnic differences occurred in the experience of symptoms, Caucasian women were more likely than African American women to report that their fears of recurrence were triggered by hearing about someone else's cancer, environmental triggers, and information or controversy about breast cancer discussed in the media. CONCLUSIONS: Illness uncertainty persisted long after cancer diagnosis and treatment, with most women experiencing multiple triggers of uncertainty about recurrence and a range of symptoms and treatment side effects. IMPLICATIONS FOR NURSING: Nurses can help cancer survivors to identify, monitor, and manage illness uncertainty and emotional distress.

Authors
Gill, KM; Mishel, M; Belyea, M; Germino, B; Germino, LS; Porter, L; LaNey, IC; Stewart, J
MLA Citation
Gill, KM, Mishel, M, Belyea, M, Germino, B, Germino, LS, Porter, L, LaNey, IC, and Stewart, J. "Triggers of uncertainty about recurrence and long-term treatment side effects in older African American and Caucasian breast cancer survivors." Oncology nursing forum 31.3 (2004): 633-639.
PMID
15146229
Source
scival
Published In
Oncology Nursing Forum
Volume
31
Issue
3
Publish Date
2004
Start Page
633
End Page
639

Cortisol levels and responses to mammography screening in breast cancer survivors: a pilot study.

OBJECTIVE: The purpose of this study was to compare baseline levels of salivary cortisol, diurnal cortisol slopes, and cortisol reactivity to a mammogram in breast cancer survivors and women without a history of cancer. METHODS: Participants were 33 breast cancer survivors (3-5 years postdiagnosis) and 21 women with no history of cancer who were scheduled for a routine follow-up mammogram. The first assessment occurred for 3 consecutive days 1 month before the mammogram, and the second assessment occurred on the day before, the day of, and the day after the mammogram. On each of these days, women completed questionnaires and collected saliva samples 6 times/day. RESULTS: Results indicated that breast cancer survivors had higher levels of cortisol at baseline than controls. There were no group differences in diurnal slopes in cortisol concentration or cortisol responses to wakening. There were group differences in cortisol responses to the mammogram: In breast cancer survivors, cortisol levels decreased from the 3-day baseline period to the 3-day period around the mammogram, whereas in the control subjects mean daily cortisol levels increased around the mammogram. Among cancer survivors, there were no significant associations between cortisol measures and general stress ratings, although there were some associations with specific psychological responses to mammography. CONCLUSIONS: Results of this pilot study indicate that breast cancer survivors show elevated levels of basal cortisol and suppressed cortisol response to a cancer-related stressor several years after completing treatment. Future research is needed to understand whether these patterns of hypothalamic-pituitary-adrenal functioning are a result of physiologic stress associated with cancer treatment or disease process, psychological stress associated with fear of recurrence, or a combination of both.

Authors
Porter, LS; Mishel, M; Neelon, V; Belyea, M; Pisano, E; Soo, MS
MLA Citation
Porter, LS, Mishel, M, Neelon, V, Belyea, M, Pisano, E, and Soo, MS. "Cortisol levels and responses to mammography screening in breast cancer survivors: a pilot study." Psychosom Med 65.5 (September 2003): 842-848.
PMID
14508030
Source
pubmed
Published In
Psychosomatic Medicine
Volume
65
Issue
5
Publish Date
2003
Start Page
842
End Page
848

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Authors
Keefe, FJ; Ahles, TA; Porter, LS; Sutton, LM; McBride, CM; Pope, MS; McKinstry, ET; Furstenberg, CP; Dalton, J; Baucom, DH
MLA Citation
Keefe, FJ, Ahles, TA, Porter, LS, Sutton, LM, McBride, CM, Pope, MS, McKinstry, ET, Furstenberg, CP, Dalton, J, and Baucom, DH. "The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life." Pain 103.1-2 (May 2003): 157-162.
PMID
12749970
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
157
End Page
162

The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses.

A number of studies have shown that catastrophizing is an important predictor of pain and disability in persons having persistent pain conditions. The newly developed communal model of catastrophizing maintains that catastrophizing is a part of broader, interpersonal style of coping in which coping efforts are directed at interpersonal goals, rather than solely at pain reduction. This study examined the potential interpersonal correlates of pain catastrophizing in a sample of 70 patients having gastrointestinal cancers and their caregivers. Measures of pain catastrophizing, perceptions of social support, pain level, and pain behavior were obtained from patients. Caregivers completed measures that included their judgments about the patient's pain level, caregiver stress, and their tendency to engage in negative responses (critical or avoidant behaviors). Overall, patients who engaged in catastrophizing reported receiving higher levels of instrumental support. Caregivers of patients who catastrophized, rated the patient as having more pain and engaging in more pain behavior. Caregivers of patients who catastrophized, also reported higher levels of caregiver stress and critical behaviors. Taken together, these preliminary findings suggest that pain catastrophizing has interpersonal correlates and support the need for additional research examining the social context of pain catastrophizing.

Authors
Keefe, FJ; Lipkus, I; Lefebvre, JC; Hurwitz, H; Clipp, E; Smith, J; Porter, L
MLA Citation
Keefe, FJ, Lipkus, I, Lefebvre, JC, Hurwitz, H, Clipp, E, Smith, J, and Porter, L. "The social context of gastrointestinal cancer pain: a preliminary study examining the relation of patient pain catastrophizing to patient perceptions of social support and caregiver stress and negative responses." Pain 103.1-2 (May 2003): 151-156.
PMID
12749969
Source
pubmed
Published In
PAIN
Volume
103
Issue
1-2
Publish Date
2003
Start Page
151
End Page
156

Daily stress and mood and their association with pain, health-care use, and school activity in adolescents with sickle cell disease

Objective To determine the extent to which daily stress and mood are associated with pain, health-care use, and school activity in adolescents with sickle cell disease (SCD). Method Adolescents with SCD (n = 37; aged 13 to 17 years) completed daily diaries assessing pain, stress, mood, activity, and health-care use for up to 6 months. Multilevel modeling was used to analyze the data. Results Daily increases in stress and negative mood were associated with increases in same-day pain, health-care use, and reductions in school and social activity. Increases in positive mood were associated with decreases in pain, less health-care use, and more activity participation. Notably, pain was predictive of higher stress and lower positive mood on subsequent days. Conclusion Pain in adolescents with SCD is stressful and may lead to alterations in mood states. Understanding the way in which these variables relate to health-care use and activity may lead to improved pain management approaches.

Authors
Gil, KM; Carson, JW; Porter, LS; Ready, J; Valrie, C; Redding-Lallinge, R; Daeschner, C
MLA Citation
Gil, KM, Carson, JW, Porter, LS, Ready, J, Valrie, C, Redding-Lallinge, R, and Daeschner, C. "Daily stress and mood and their association with pain, health-care use, and school activity in adolescents with sickle cell disease." Journal of Pediatric Psychology 28.5 (2003): 363-373.
PMID
12808013
Source
scival
Published In
Journal of Pediatric Psychology
Volume
28
Issue
5
Publish Date
2003
Start Page
363
End Page
373
DOI
10.1093/jpepsy/jsg026

Cancer pain at the end of life: a biopsychosocial perspective.

Authors
Sutton, LM; Porter, LS; Keefe, FJ
MLA Citation
Sutton, LM, Porter, LS, and Keefe, FJ. "Cancer pain at the end of life: a biopsychosocial perspective." Pain 99.1-2 (September 2002): 5-10. (Review)
PMID
12237179
Source
pubmed
Published In
PAIN
Volume
99
Issue
1-2
Publish Date
2002
Start Page
5
End Page
10

Perceptions of patients’ self-efficacy for managing pain and lung cancer symptoms: Correspondence between patients and family caregivers

Authors
Porter, LS; Keefe, FJ; McBride, CM; Pollak, K; Fish, L; Garst, J
MLA Citation
Porter, LS, Keefe, FJ, McBride, CM, Pollak, K, Fish, L, and Garst, J. "Perceptions of patients’ self-efficacy for managing pain and lung cancer symptoms: Correspondence between patients and family caregivers." Pain 98 (2002): 169-178. (Academic Article)
PMID
12098629
Source
manual
Published In
Pain
Volume
98
Publish Date
2002
Start Page
169
End Page
178

Pain in children and adolescents with sickle cell disease: An analysis of daily pain diaries

The purpose of this study was to analyze daily patterns of pain, medication use, health care use, and activity reduction during pain episodes in children and adolescents with sickle cell disease (SCD). The parents of 34 children and adolescents ages 6 to 17 years completed a daily diary about their children's pain response for 14 days. Eight of the adolescents (ages 13-17) concurrently but independently completed the same diaries. The results indicate that children with SCD usually experienced low levels of pain that was managed at home, sometimes without any medications. Multilevel random effects models indicated that as pain levels increased, children were more likely to use narcotic medications and health care services, although overall health care utilization during the 2-week period tended to be relatively infrequent. On average, children considerably reduced school, household, and social activities when in pain. Moreover, parents and adolescents generally agreed on daily pain response, especially for salient events such as health care visits.

Authors
Gil, KM; Porter, L; Ready, J; Workman, E; Sedway, J; Anthony, KK
MLA Citation
Gil, KM, Porter, L, Ready, J, Workman, E, Sedway, J, and Anthony, KK. "Pain in children and adolescents with sickle cell disease: An analysis of daily pain diaries." Children's Health Care 29.4 (2000): 225-241.
Source
scival
Published In
Children's Health Care
Volume
29
Issue
4
Publish Date
2000
Start Page
225
End Page
241

The role of stress and mood in sickle cell disease pain. An analysis of daily diary data

The role of stress and mood in the onset and course of sickle cell disease (SCD) pain was examined using a daily diary design. Fifteen adults with SCD completed daily diaries about their pain, stress, mood, and health care and medication use for an average of 94 days. Multilevel random effects models indicated that stress was significantly and positively related to same-day pain ratings. Stress remained a significant predictor of pin after omitting stressors related to SCD. Mood also showed significant associations with same-day pain in the expected directions. In addition, stress and mood were associated with health care and medication use during painful episodes. Finally, painful episodes were preceded by increases in stress 2 days previously, suggesting that stress may play a role in the onset of SCD pain.

Authors
Porter, LS; Gil, KM; Carson, JW; Anthony, KK; Ready, J
MLA Citation
Porter, LS, Gil, KM, Carson, JW, Anthony, KK, and Ready, J. "The role of stress and mood in sickle cell disease pain. An analysis of daily diary data." Journal of Health Psychology 5.1 (2000): 53-63.
Source
scival
Published In
Journal of Health Psychology
Volume
5
Issue
1
Publish Date
2000
Start Page
53
End Page
63

Gender differences in coping: A comparison of trait and momentary assessments

Gender differences in coping were examined using trait and and momentary situation-specific forms of the Daily Coping Inventory (DCI) and the Ways of Coping (WOC) questionnaire. The momentary measure also included assessment of problem content and appraisal. Participants were 47 men and 48 women (mean age = 42; 97% Caucasian) with high levels of work or marital stress. Participants completed trait versions of the DCI and WOC at the start of the study. Over the next two days, they carried an electronic diary which randomly prompted them every 40 minutes to report on their stressors, stress appraisals, and coping efforts. Analysis of the trait data indicated gender differences in coping consistent with what would be predicted by the socialization hypothesis: Women reported greater use of social support and catharsis on the DCI than men. However, no gender differences in coping were observed on the momentary assessments. Overall, the pattern of results suggest that previous findings of gender differences in coping may be attributable to heuristic recall strategies based on conventional gender role stereotypes, rather than to actual differences in behavior.

Authors
Porter, LS; Marco, CA; Schwartz, JE; Neale, JM; Shiffman, S; Stone, AA
MLA Citation
Porter, LS, Marco, CA, Schwartz, JE, Neale, JM, Shiffman, S, and Stone, AA. "Gender differences in coping: A comparison of trait and momentary assessments." Journal of Social and Clinical Psychology 19.4 (2000): 480-498.
Source
scival
Published In
Journal of Social and Clinical Psychology
Volume
19
Issue
4
Publish Date
2000
Start Page
480
End Page
498

Follow-up of coping skills training in adults with sickle cell disease: Analysis of daily pain and coping practice diaries

This study examined the 3-month follow-up effects of a pain coping skills intervention in African American adults with sickle cell disease. Sixty-seven participants were randomly assigned to either a coping skills condition or a disease-eduction control condition. Multivariate analyses applied to summary measures of coping, laboratory pain perception, and clinical measures indicated that participants in the coping intervention reported significantly lower laboratory pain and significantly higher coping attempts at 3-month follow-up in comparison with the control condition. Multilevel random effects models applied to prospective daily diaries of daily pain, health care contacts, and coping practice indicated that on pain days when participants practiced their strategies, they had less major health care contacts in comparison with days when they did not use strategies.

Authors
Gil, KM; Carsona, JW; Sedway, JA; Porter, LS; Schaeffer, JJW; Orringer, E
MLA Citation
Gil, KM, Carsona, JW, Sedway, JA, Porter, LS, Schaeffer, JJW, and Orringer, E. "Follow-up of coping skills training in adults with sickle cell disease: Analysis of daily pain and coping practice diaries." Health Psychology 19.1 (2000): 85-90.
PMID
10711591
Source
scival
Published In
Health Psychology
Volume
19
Issue
1
Publish Date
2000
Start Page
85
End Page
90
DOI
10.1037//0278-6133.19.1.85

Social desirability in patients seeking surgical treatment for dentofacial disharmony: Associations with psychological distress and motivation for treatment

The role of socially desirable responding in the report of treatment motivation and psychological distress by patients seeking surgical treatment for dentofacial disharmony was explored. Participants completed the Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1988), which measures two components of socially desirable responding (SDR): impression management (IM), which is the purposeful tailoring of answers in order to create the most positive social image, and self-deceptive positivity (SDE), which is an honest, but overly positive self-presentation. When simple bivariate relationships were examined, statistically significant inverse associations were observed between socially desirable responding and specific motives for treatment and between SDR and psychological distress. However, the relationship between socially desirable responding and motives for treatment disappeared when the effect of psychological distress was controlled. The positive relationship between psychological distress and the report of social well-being, and self-image motives for treatment remained statistically significant even after the variance attributable to socially desirable responding was removed. Implications of the findings for the evaluation of psychological distress and treatment motivation in this population are discussed. © 2000 Plenum Publishing Corporation.

Authors
Porter, LS; Phillips, C; Dickens, S; Kiyak, HA
MLA Citation
Porter, LS, Phillips, C, Dickens, S, and Kiyak, HA. "Social desirability in patients seeking surgical treatment for dentofacial disharmony: Associations with psychological distress and motivation for treatment." Journal of Clinical Psychology in Medical Settings 7.2 (2000): 99-106.
Source
scival
Published In
Journal of Clinical Psychology in Medical Settings
Volume
7
Issue
2
Publish Date
2000
Start Page
99
End Page
106

Does the peak-end phenomenon observed in laboratory pain studies apply to real-world pain in rheumatoid arthritics?

Laboratory studies and investigations of patients undergoing painful procedures have compared recalled pain to an average of multiple momentary reports taken throughout the painful experience. This work has shown that recalled ratings of pain are more closely associated with a combination of peak pain and pain proximal to the recall ratings than an average of all momentary reports. However, these studies have examined recalled pain over relatively short periods, usually under 1 hour. In this study of 32 patients with rheumatoid arthritis, momentary pain ratings taken over a 7-day period were compared with pain recalled on the eighth day. Analyses confirmed that a combination of peak and recent pain was a better predictor of recalled patient pain than was a simple average of all momentary pain reports. These results extend our understanding of how individuals remember pain and suggest alternative methods for assessing recalled pain.

Authors
Stone, AA; Broderick, JE; Kaell, AT; DelesPaul, PAEG; Porter, LE
MLA Citation
Stone, AA, Broderick, JE, Kaell, AT, DelesPaul, PAEG, and Porter, LE. "Does the peak-end phenomenon observed in laboratory pain studies apply to real-world pain in rheumatoid arthritics?." Journal of Pain 1.3 (2000): 212-217.
Source
scival
Published In
The Journal of Pain
Volume
1
Issue
3
Publish Date
2000
Start Page
212
End Page
217
DOI
10.1054/jpai.2000.7568

Anger expression and ambulatory blood pressure: A comparison of state and trait measures

Objectives: The goals of this study were (1) to compare trait and state measures of anger expression, (2) to examine associations between situational variables and anger expression, and (3) to examine relationships between trait and state anger expression and ambulatory blood pressure. Methods: One hundred college students completed state and trait versions of the Spielberger (1) anger expression scale. State measures were completed in response to specific anger-provoking situations as they occurred over a 7-day period. Ambulatory blood pressure was recorded on one of these days. Results: Moderate correlations were observed between trait and state anger expression. Significant associations were found between a number of situational variables and state anger expression scales. Neither trait nor state anger expressions scales were related to blood pressure levels. Conclusions: These results indicate that trait and state measures of anger expression are not equivalent and that situational factors play an important role in anger expression. Situational variability may be an important factor in determining the health consequences of anger expression.

Authors
Porter, LS; Stone, AA; Schwartz, JE
MLA Citation
Porter, LS, Stone, AA, and Schwartz, JE. "Anger expression and ambulatory blood pressure: A comparison of state and trait measures." Psychosomatic Medicine 61.4 (1999): 454-463.
PMID
10443753
Source
scival
Published In
Psychosomatic Medicine
Volume
61
Issue
4
Publish Date
1999
Start Page
454
End Page
463

A comparison of coping assessed by ecological momentary assessment and retrospective recall

Recent research suggests that retrospective coping assessments may not correspond well with day-to-day reports. The authors extended this work by examining the correspondence between short-term (within 48 hr) retrospective coping reports and momentary reports recorded via a palm-top computer close in time to when the stressor occurred. There was relatively poor correspondence between the 2 assessments. Some reports of momentary coping were not reported retrospectively, and some coping reported retrospectively was not reported at the time the stressor occurred. Cognitive coping was more likely to be underreported retrospectively; behavioral coping was overreported. Participants were consistent in their discrepancies, but there was no correspondence between discrepancy rates and demographic or personality variables. Copyright 1998 by the American Psychological Association, Inc.

Authors
Stone, AA; Schwartz, JE; Neale, JM; Marco, CA; Shiffman, S; Hickcox, M; Paty, J; Porter, LS; Cruise, LJ
MLA Citation
Stone, AA, Schwartz, JE, Neale, JM, Marco, CA, Shiffman, S, Hickcox, M, Paty, J, Porter, LS, and Cruise, LJ. "A comparison of coping assessed by ecological momentary assessment and retrospective recall." Journal of Personality and Social Psychology 74.6 (1998): 1670-1680.
PMID
9654765
Source
scival
Published In
Journal of Personality and Social Psychology
Volume
74
Issue
6
Publish Date
1998
Start Page
1670
End Page
1680

Stressors and mood measured on a momentary basis are associated with salivary cortisol secretion

Effects of past, current, and anticipated naturalistic daily stressors and of affect on salivary cortisol levels were examined. Participants (120) reported on stressors and affect 6 x /day in response to a preprogrammed wristwatch. Twenty min after each assessment they took a sample of saliva for cortisol analysis. Both the experience of a current stressor and anticipating a stressor were associated with increased salivary cortisol levels. Average increases in cortisol were relatively low, but inter-individual variability in this response existed. Stressors also were associated with lower positive affect and higher negative affect. Negative affect was associated with higher cortisol levels and positive affect was associated with lower cortisol levels. Daily stressors were not significant predictors of cortisol secretion when affect was controlled. Momentary assessment of daily stressors and of salivary cortisol proved to be a useful tool for examining psychoendocrinological processes in the natural environment.

Authors
Smyth, J; Ockenfels, MC; Porter, L; Kirschbaum, C; Hellhammer, DH; Stone, AA
MLA Citation
Smyth, J, Ockenfels, MC, Porter, L, Kirschbaum, C, Hellhammer, DH, and Stone, AA. "Stressors and mood measured on a momentary basis are associated with salivary cortisol secretion." Psychoneuroendocrinology 23.4 (1998): 353-370.
PMID
9695136
Source
scival
Published In
Psychoneuroendocrinology
Volume
23
Issue
4
Publish Date
1998
Start Page
353
End Page
370
DOI
10.1016/S0306-4530(98)00008-0

Pain and stress in sickle cell disease: An analysis of daily pain records

This study examined daily reports of pain, medication use, health care use, and activity reduction in adults with sickle cell disease, and their association with stress. Participants were 53 adults with sickle cell disease. They completed the Daily Hassles questionnaire at the start of the study, and they kept daily records of pain and pain response over the following 14 days. On average, patients reported pain on 6.5 days of the 14- day study period. The average pain intensity rating during a painful episode was 4.4 on a 10-point scale. Pain was most often managed at home. Patients took medication (analgesics and/or narcotics) on 80% of the days they experienced pain, and they were more likely to use medication, particularly narcotics, as pain levels increased. At higher pain levels some patients also utilized a range of health care services. On average, patients also cut back considerably on household and social activities, especially when pain reached a level of over 5 on the 10-point scale. Those who were employed, however, were likely to continue to work, even when in pain. In addition, stress had significant positive associations with average pain intensity as well as reductions in household and social activities. Furthermore, stress predicted activity reductions even after controlling for pain intensity. Stress was unrelated to medication and health care use in this study.

Authors
Porter, LS; Gil, KM; Sedway, JA; Ready, J; Workman, E; Jr, RJT
MLA Citation
Porter, LS, Gil, KM, Sedway, JA, Ready, J, Workman, E, and Jr, RJT. "Pain and stress in sickle cell disease: An analysis of daily pain records." International Journal of Behavioral Medicine 5.3 (1998): 185-203.
PMID
16250701
Source
scival
Published In
International Journal of Behavioral Medicine
Volume
5
Issue
3
Publish Date
1998
Start Page
185
End Page
203
DOI
10.1207/s15327558ijbm0503_1

The experience of rheumatoid arthritis pain and fatigue: Examining momentary reports and correlates over one week

Objective. To evaluate the daily experience of patients with rheumatoid arthritis (RA) in an ecologically valid manner; Ecological Momentary Assessment (EMA) was employed. Diurnal cycles and within-day variation of self-reported pain and fatigue were examined as were relationships between pain, fatigue, daily stressful events, and sleep. Methods. Thirty-five patients with RA were alerted with an electronic beep 7 times per day for 7 consecutive days. Assessments were recorded at each beep. Upon awakening each day, sleep information was reported. Results. There were large individual differences in variation of pain and fatigue. Stressors were associated with increased pain but not fatigue. Subjects with poor sleep had higher levels of pain and fatigue. Diurnal cycles of pain and fatigue were found, yet were observed for only some patients (37% and 34%, respectively). Conclusion. The use of EMA deepens our understanding of the pain and fatigue experienced by RA patients. This method may help identify subgroups of patients who are highly 'psychoreactive' to environmental stimuli and/or who have diurnal patterns to their symptoms. It may also be used to improve existing instruments.

Authors
Stone, AA; Broderick, JE; Porter, LS; Kaell, AT
MLA Citation
Stone, AA, Broderick, JE, Porter, LS, and Kaell, AT. "The experience of rheumatoid arthritis pain and fatigue: Examining momentary reports and correlates over one week." Arthritis Care and Research 10.3 (1997): 185-193.
Source
scival
Published In
Arthritis Care and Research
Volume
10
Issue
3
Publish Date
1997
Start Page
185
End Page
193

Individual differences in the diurnal cycle of cortisol

This study investigated individual differences in the diurnal cycle of cortisol and explored their relation to several psychosocial variables and to upper-respiratory symptoms. Cortisol and daily experience were assessed for 2 days in 109 healthy employed and unemployed community residents (mean age = 36.4 ± 12.1, 69% female); self-report upper respiratory illness (URI) symptoms were assessed for an additional 10 days. Fifty-six (51%) participants showed typical declines in cortisol during both days, 19 (17%) showed no significant diurnal pattern on both days, and 34 (31%) showed different diurnal patterns on the 2 days. Individuals with no cycles did not differ from those with normal or inconsistent cycles on demographic factors, baseline psychological measures, health behaviors, or daily experiences over the two assessment days. Individuals without cortisol cycles, however, reported fewer URI symptoms than the remaining subjects. That 17% of our sample did not exhibit diurnal cycles of cortisol was surprising, given established views of normal endocrine function. Although average daily level of cortisol is related to a number of psychosocial and psychiatric factors (e.g. stress and depression), pattern of diurnal cycle was not related to any demographic or psychosocial measures in this study. The finding that flat cycles were related to fewer reports of URI symptoms suggests that perturbations in cycle may be related to processes associated with symptom susceptibility or symptom expression.

Authors
Smyth, JM; Ockenfels, MC; Gorin, AA; Catley, D; Porter, LS; Kirschbaum, C; Hellhammer, DH; Stone, AA
MLA Citation
Smyth, JM, Ockenfels, MC, Gorin, AA, Catley, D, Porter, LS, Kirschbaum, C, Hellhammer, DH, and Stone, AA. "Individual differences in the diurnal cycle of cortisol." Psychoneuroendocrinology 22.2 (1997): 89-105.
PMID
9149331
Source
scival
Published In
Psychoneuroendocrinology
Volume
22
Issue
2
Publish Date
1997
Start Page
89
End Page
105
DOI
10.1016/S0306-4530(96)00039-X

Reactive effects of diary self-assessment in chronic pain patients

Several studies of experimental and acute clinical pain have indicated reactive effects of self-assessment on pain intensity and tolerance. A recent study of chronic pain patients (vonBaeyer 1994), however, failed to show these effects. The present investigation sought to determine whether reactive effects can be produced in chronic pain patients by an intensive self-assessment protocol. Using the methodology of ecological momentary assessment (EMA; Stone and Shiffman 1994), thirty-five chronic rheumatoid arthritis patients completed diaries of pain and mood seven times a day for 1 wk. Eighteen patients were included in the final sample because they responded to at least half of the number of hourly prompts for each of the 7 days. Using repeated measures analysis of the daily means, no significant effects of time were found for any measures. Reactive effects that result in an average change in pain levels over time, therefore, do not appear to be produced by intensive self-assessment in a naturalistic context. Results are discussed in terms of cognitive and behavioral theories of pain reactivity.

Authors
Cruise, CE; Broderick, J; Porter, L; Kaell, A; Stone, AA
MLA Citation
Cruise, CE, Broderick, J, Porter, L, Kaell, A, and Stone, AA. "Reactive effects of diary self-assessment in chronic pain patients." Pain 67.2-3 (1996): 253-258.
PMID
8951918
Source
scival
Published In
PAIN
Volume
67
Issue
2-3
Publish Date
1996
Start Page
253
End Page
258
DOI
10.1016/0304-3959(96)03125-9

Effect of chronic stress associated with unemployment on salivary cortisol: Overall cortisol levels, diurnal rhythm, and acute stress reactivity

This study examined the effect of chronic stress associated with unemployment on the magnitude of salivary cortisol excretion, on the diurnal rhythm of cortisol, and on cortisol reactivity to acute naturalistic stressors using Experience Sampling Methodology (ESM). Employed (N = 60) and unemployed (N = 60) subjects were studied for 2 days. Subjects were beeped 6 times per day by a preprogrammed wristwatch to assess acute stressors; 25 minutes after each ESM-beep, subjects were beeped a second time for saliva samples. The groups did not differ in their overall cortisol excretion or in cortisol reactivity to acute daily stressors. Compared to employed subjects, unemployed subjects had a diurnal pattern of cortisol excretion with relatively higher morning and lower evening levels. Subjects' daily activities and their locations were associated with diurnal rhythm differences.

Authors
Ockenfels, MC; Porter, L; Smyth, J; Kirschbaum, C; Hellhammer, DH; Stone, AA
MLA Citation
Ockenfels, MC, Porter, L, Smyth, J, Kirschbaum, C, Hellhammer, DH, and Stone, AA. "Effect of chronic stress associated with unemployment on salivary cortisol: Overall cortisol levels, diurnal rhythm, and acute stress reactivity." Psychosomatic Medicine 57.5 (1995): 460-467.
PMID
8552737
Source
scival
Published In
Psychosomatic Medicine
Volume
57
Issue
5
Publish Date
1995
Start Page
460
End Page
467

Fatigue and mood in chronic fatigue syndrome patients: Results of a momentary assessment protocol examining fatigue and mood levels and diurnal patterns

Examined the overall levels and the diurnal patterns of fatigue, mood, and activities in chronic fatigue syndrome (CFS) patients using computer-prompted assessments at random points throughout many days. We hypothesized that levels of fatigue and mood would be different in the groups and that diurnal patterns would also differ by group. Momentary assessment methods avoid many potential biases inherent in retrospective recall techniques. Eight CFS patients and 21 community-dwelling control subjects were randomly prompted between five and six times per day and responded to questions about fatigue, positive affect, negative affect, and the activities they were engaged in at the moment of the prompt. CFS patients participated for 26 days and control subjects participated for 15 days. Compared to the control group, levels of fatigue were higher in the CFS group, yet there were no differences in overall level of positive or negative affect. Strong diurnal patterns of affect were observed for fatigue measures indicating that it was higher in the morning and evening. Diurnal patterns were also observed for mood. Positive affect increased over the day and negative affect decreased. There was very modest support for differential diurnal patterns by group: the effect was only evident for one of the positive affect adjectives. Finally, these results were not diminished when the activities subjects were engaged in at the time of the assessments were controlled.

Authors
Stone, AA; Broderick, JE; Porter, LS; Krupp, L; Gnys, M; Paty, JA; Shiffman, S
MLA Citation
Stone, AA, Broderick, JE, Porter, LS, Krupp, L, Gnys, M, Paty, JA, and Shiffman, S. "Fatigue and mood in chronic fatigue syndrome patients: Results of a momentary assessment protocol examining fatigue and mood levels and diurnal patterns." Annals of Behavioral Medicine 16.3 (1994): 228-234.
Source
scival
Published In
Annals of Behavioral Medicine
Volume
16
Issue
3
Publish Date
1994
Start Page
228
End Page
234

Daily events and mood prior to the onset of respiratory illness episodes: A non-replication of the 3-5 day 'desirability dip'

We attempted to replicate and extend the findings of three previous studies that found a lagged relationship between daily life events, mood and the onset of episodes of respiratory illness. The findings and methods of the three previous studies are reviewed, and similarities and differences in their analytic approaches are discussed. Seventy-nine middle-aged male subjects completed daily records of life events, mood and symptoms for an average of 83 days. Twenty-three men suffered at least one illness episode that met our selection criteria. Using the methodology of Stone et al. and Evans et al., we were unable to detect a relationship between daily events or mood and the onset of illness episodes. The necessity of standardizing procedures of defining illness episodes and control days and the importance of including analyses of variables that may mediate the relationship between events and illness are discussed.

Authors
Stone, AA; Porter, LS; Neale, JM
MLA Citation
Stone, AA, Porter, LS, and Neale, JM. "Daily events and mood prior to the onset of respiratory illness episodes: A non-replication of the 3-5 day 'desirability dip'." British Journal of Medical Psychology 66.4 (1993): 383-393.
PMID
8123606
Source
scival
Published In
British Journal of Medical Psychology
Volume
66
Issue
4
Publish Date
1993
Start Page
383
End Page
393
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