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Shelby, Rebecca A

Overview:

Rebecca Shelby, Ph.D. is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Duke University and the Director of Education and Training for the Duke Cancer Patient Support Program.  Dr. Shelby is a member of the Duke Pain Prevention and Treatment Research Program and the Duke Cancer Control and Population Sciences Program. Dr. Shelby completed her graduate training in clinical psychology at the Ohio State University and her clinical internship and postdoctoral fellowship at Duke University Medical Center.  Her research focuses on developing and evaluating behavioral interventions for cancer patients, management of cancer pain and treatment side effects, and improving adherence to recommended care. Dr. Shelby serves on the Duke clinical psychology internship faculty and supervises clinical psychology fellows, interns, and clinical psychology graduate practicum students completing clinical rotations as part of the Duke Cancer Patient Support Program.   

Positions:

Assistant Professor of Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2006

Ph.D. — Ohio State University

Grants:

Improving Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
July 01, 2016
End Date
June 30, 2021

Optimizing Delivery of a Behavioral Cancer Pain Intervention Using a SMART

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Clinical Associate
Start Date
June 01, 2016
End Date
May 31, 2021

A Self-Management Intervention for Women with Breast Cancer and Diabetes

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Principal Investigator
Start Date
July 01, 2016
End Date
June 30, 2020

Behavioral Weight and Symptom Management for Breast Cancer Survivors and Partners

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co-Mentor
Start Date
September 01, 2015
End Date
August 31, 2018

Coping Skills for Colorectal Cancer Survivors with Pain and Distress

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
American Cancer Society, Inc.
Role
Co-Mentor
Start Date
July 01, 2015
End Date
June 30, 2018

Home-Based Tablet Computer Pain Coping Skills Following Stem Cell Transplant

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Co Investigator
Start Date
September 10, 2013
End Date
August 31, 2015

Improving Adherence to Recommended Surveillance in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
Principal Investigator
Start Date
September 01, 2010
End Date
August 31, 2015

Mammography Pain in Breast Cancer Survivors

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
AwardedBy
National Institutes of Health
Role
PI-Fellow
Start Date
September 04, 2006
End Date
September 03, 2009
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Publications:

Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue.

Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patients from pre to post transplant. Patients undergoing HSCT (N=138) completed questionnaires at pre-transplant and during the 12 months following transplant. Questionnaires assessed sleep and cognitive problems as well as commonly co-occurring symptoms: depressive symptoms, fatigue and pain. Post hoc analyses examined the relationship of specific sleep problems with cognitive problems. Sleep problems covaried with cognitive problems even after controlling for depressive symptoms, fatigue and pain. Depressive symptoms and fatigue were also uniquely related to cognitive problems. Post hoc analyses suggest that sleep somnolence, shortness of breath, snoring and perceptions of inadequate sleep may contribute to the association found between sleep and cognitive problems. Findings suggest that sleep problems are associated with and may contribute to cognitive problems for HSCT patients. However, sleep problems are rarely screened for or discussed during clinic visits. Assessing and treating specific sleep problems in addition to depressive symptoms and fatigue may have implications for improving cognitive problems for HSCT patients.

Authors
Ghazikhanian, SE; Dorfman, CS; Somers, TJ; O'Sullivan, ML; Fisher, HM; Edmond, SN; Wren, AA; Kelleher, SA; Rowe Nichols, KA; Chao, N; Shelby, RA
MLA Citation
Ghazikhanian, SE, Dorfman, CS, Somers, TJ, O'Sullivan, ML, Fisher, HM, Edmond, SN, Wren, AA, Kelleher, SA, Rowe Nichols, KA, Chao, N, and Shelby, RA. "Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue." Bone marrow transplantation 52.2 (February 2017): 279-284.
PMID
27941775
Source
epmc
Published In
Bone Marrow Transplantation
Volume
52
Issue
2
Publish Date
2017
Start Page
279
End Page
284
DOI
10.1038/bmt.2016.248

Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer.

This study compared persistent breast pain among women who received breast-conserving surgery for breast cancer and women without a history of breast cancer.Breast cancer survivors (n=200) were recruited at their first postsurgical surveillance mammogram (6 to 15 mo postsurgery). Women without a breast cancer history (n=150) were recruited at the time of a routine screening mammogram. All women completed measures of breast pain, pain interference with daily activities and intimacy, worry about breast pain, anxiety symptoms, and depression symptoms. Demographic and medical information were also collected.Persistent breast pain (duration ≥6 mo) was reported by 46.5% of breast cancer survivors and 12.7% of women without a breast cancer history (P<0.05). Breast cancer survivors also had significantly higher rates of clinically significant persistent breast pain (pain intensity score ≥3/10), as well as higher average breast pain intensity and unpleasantness scores. Breast cancer survivors with persistent breast pain had significantly higher levels of depressive symptoms, as well as pain worry and interference, compared with survivors without persistent breast pain or women without a breast cancer history. Anxiety symptoms were significantly higher in breast cancer survivors with persistent breast pain compared with women without a breast cancer history.Results indicate that persistent breast pain negatively impacts women with a history of breast-conserving cancer surgery compared with women without that history. Strategies to ameliorate persistent breast pain and to improve adjustment among women with persistent breast pain should be explored for incorporation into standard care for breast cancer survivors.

Authors
Edmond, SN; Shelby, RA; Keefe, FJ; Fisher, HM; Schmidt, JE; Soo, MS; Skinner, CS; Ahrendt, GM; Manculich, J; Sumkin, JH; Zuley, ML; Bovbjerg, DH
MLA Citation
Edmond, SN, Shelby, RA, Keefe, FJ, Fisher, HM, Schmidt, JE, Soo, MS, Skinner, CS, Ahrendt, GM, Manculich, J, Sumkin, JH, Zuley, ML, and Bovbjerg, DH. "Persistent Breast Pain Among Women With Histories of Breast-conserving Surgery for Breast Cancer Compared With Women Without Histories of Breast Surgery or Cancer." The Clinical journal of pain 33.1 (January 2017): 51-56.
PMID
27922843
Source
epmc
Published In
Clinical Journal of Pain
Volume
33
Issue
1
Publish Date
2017
Start Page
51
End Page
56

Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results.

Positive and negative mood are independent psychological responses to stressful events. Negative mood negatively impacts well-being and co-occurring positive mood leads to improved adjustment. Women undergoing core needle breast biopsies (CNB) experience distress during CNB and awaiting results; however, influences of mood are not well known. This longitudinal study examines psychosocial and biopsy- and spirituality-related factors associated with mood in patients day of CNB and one week after receiving results. Ninety women undergoing CNB completed questionnaires on psychosocial factors (chronic stress, social support), biopsy experiences (pain, radiologist communication), and spirituality (peace, meaning, faith) day of CNB. Measures of positive and negative mood were completed day of CNB and one week after receiving results (benign n = 50; abnormal n = 25). Multiple linear regression analyses were conducted. Greater positive mood correlated with greater peace (β = .25, p = .02) day of CNB. Lower negative mood correlated with greater peace (β = -.29, p = .004) and there was a trend for a relationship with less pain during CNB (β = .19, p = .07). For patients with benign results, day of CNB positive mood predicted positive mood post-results (β = .31, p = .03) and only chronic stress predicted negative mood (β = .33, p = .03). For women with abnormal results, greater meaning day of CNB predicted lower negative mood post-results (β = -.45, p = .03). Meaning and peace may be important for women undergoing CNB and receiving abnormal results.

Authors
Perlman, KL; Shelby, RA; Wren, AA; Kelleher, SA; Dorfman, CS; O'Connor, E; Kim, C; Johnson, KS; Soo, MS
MLA Citation
Perlman, KL, Shelby, RA, Wren, AA, Kelleher, SA, Dorfman, CS, O'Connor, E, Kim, C, Johnson, KS, and Soo, MS. "Positive and negative mood following imaging-guided core needle breast biopsy and receipt of biopsy results." Psychology, health & medicine (December 23, 2016): 1-14.
PMID
28007008
Source
epmc
Published In
Psychology, Health & Medicine
Publish Date
2016
Start Page
1
End Page
14
DOI
10.1080/13548506.2016.1271438

Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults.

Discussions about sexual health are uncommon in clinical encounters, despite the sexual dysfunction associated with many common health conditions. Understanding of the importance of sexual health and sexual satisfaction in U.S. adults is limited.To provide epidemiologic data on the importance of sexual health for quality of life and people's satisfaction with their sex lives and to examine how each is associated with demographic and health factors.Data are from a cross-sectional self-report questionnaire from a sample of 3,515 English-speaking U.S. adults recruited from an online panel that uses address-based probability sampling.We report ratings of importance of sexual health to quality of life (single item with five-point response) and the Patient-Reported Outcomes Measurement Information System Satisfaction With Sex Life score (five items, each with five-point responses, scores centered on the U.S. mean).High importance of sexual health to quality of life was reported by 62.2% of men (95% CI = 59.4-65.0) and 42.8% of women (95% CI = 39.6-46.1, P < .001). Importance of sexual health varied by sex, age, sexual activity status, and general self-rated health. For the 55% of men and 45% of women who reported sexual activity in the previous 30 days, satisfaction with sex life differed by sex, age, race-ethnicity (among men only), and health. Men and women in excellent health had significantly higher satisfaction than participants in fair or poor health. Women with hypertension reported significantly lower satisfaction (especially younger women), as did men with depression or anxiety (especially younger men).In this large study of U.S. adults' ratings of the importance of sexual health and satisfaction with sex life, sexual health was a highly important aspect of quality of life for many participants, including participants in poor health. Moreover, participants in poorer health reported lower sexual satisfaction. Accordingly, sexual health should be a routine part of clinicians' assessments of their patients. Health care systems that state a commitment to improving patients' overall health must have resources in place to address sexual concerns. These resources should be available for all patients across the lifespan.

Authors
Flynn, KE; Lin, L; Bruner, DW; Cyranowski, JM; Hahn, EA; Jeffery, DD; Reese, JB; Reeve, BB; Shelby, RA; Weinfurt, KP
MLA Citation
Flynn, KE, Lin, L, Bruner, DW, Cyranowski, JM, Hahn, EA, Jeffery, DD, Reese, JB, Reeve, BB, Shelby, RA, and Weinfurt, KP. "Sexual Satisfaction and the Importance of Sexual Health to Quality of Life Throughout the Life Course of U.S. Adults." The journal of sexual medicine 13.11 (November 2016): 1642-1650.
PMID
27671968
Source
epmc
Published In
The Journal of Sexual Medicine
Volume
13
Issue
11
Publish Date
2016
Start Page
1642
End Page
1650
DOI
10.1016/j.jsxm.2016.08.011

Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication.

The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy.After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses.Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P = .01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P < .001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P = .04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists.Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening.

Authors
Miller, LS; Shelby, RA; Balmadrid, MH; Yoon, S; Baker, JA; Wildermann, L; Soo, MS
MLA Citation
Miller, LS, Shelby, RA, Balmadrid, MH, Yoon, S, Baker, JA, Wildermann, L, and Soo, MS. "Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication." Journal of the American College of Radiology : JACR 13.11S (November 2016): e62-e71.
PMID
27814826
Source
epmc
Published In
Journal of the American College of Radiology
Volume
13
Issue
11S
Publish Date
2016
Start Page
e62
End Page
e71
DOI
10.1016/j.jacr.2016.09.034

Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial.

Persistent low back pain (PLBP) is associated with vulnerability to depression. PLBP frequently requires major changes in occupation and lifestyle, which can lead to a sense of failing to attain one's personal goals (self-discrepancy).We conducted a clinical trial to examine the efficacy of self-system therapy (SST), a brief structured therapy for depression based on self-discrepancy theory. A total of 101 patients with PLBP and clinically significant depressive symptoms were randomized either to SST, pain education, or standard care.Patients receiving SST showed significantly greater improvement in depressive symptoms. Reduction in self-discrepancy predicted reduction in depressive symptoms only within the SST condition.Findings support the utility of SST for individuals facing persistent pain and associated depression.

Authors
Waters, SJ; Strauman, TJ; McKee, DC; Campbell, LC; Shelby, RA; Dixon, KE; Fras, AM; Keefe, FJ
MLA Citation
Waters, SJ, Strauman, TJ, McKee, DC, Campbell, LC, Shelby, RA, Dixon, KE, Fras, AM, and Keefe, FJ. "Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial." Psychotherapy research : journal of the Society for Psychotherapy Research 26.4 (July 2016): 472-483.
Website
http://hdl.handle.net/10161/13839
PMID
26079438
Source
epmc
Published In
Psychotherapy Research
Volume
26
Issue
4
Publish Date
2016
Start Page
472
End Page
483
DOI
10.1080/10503307.2015.1040485

Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue.

To evaluate the impact of guided meditation and music interventions on patient anxiety, pain, and fatigue during imaging-guided breast biopsy.After giving informed consent, 121 women needing percutaneous imaging-guided breast biopsy were randomized into three groups: (1) guided meditation; (2) music; (3) standard-care control group. During biopsy, the meditation and music groups listened to an audio-recorded, guided, loving-kindness meditation and relaxing music, respectively; the standard-care control group received supportive dialogue from the biopsy team. Immediately before and after biopsy, participants completed questionnaires measuring anxiety (State-Trait Anxiety Inventory Scale), biopsy pain (Brief Pain Inventory), and fatigue (modified Functional Assessment of Chronic Illness Therapy-Fatigue). After biopsy, participants completed questionnaires assessing radiologist-patient communication (modified Questionnaire on the Quality of Physician-Patient Interaction), demographics, and medical history.The meditation and music groups reported significantly greater anxiety reduction (P values < .05) and reduced fatigue after biopsy than the standard-care control group; the standard-care control group reported increased fatigue after biopsy. The meditation group additionally showed significantly lower pain during biopsy, compared with the music group (P = .03). No significant difference in patient-perceived quality of radiologist-patient communication was noted among groups.Listening to guided meditation significantly lowered biopsy pain during imaging-guided breast biopsy; meditation and music reduced patient anxiety and fatigue without compromising radiologist-patient communication. These simple, inexpensive interventions could improve women's experiences during core-needle breast biopsy.

Authors
Soo, MS; Jarosz, JA; Wren, AA; Soo, AE; Mowery, YM; Johnson, KS; Yoon, SC; Kim, C; Hwang, ES; Keefe, FJ; Shelby, RA
MLA Citation
Soo, MS, Jarosz, JA, Wren, AA, Soo, AE, Mowery, YM, Johnson, KS, Yoon, SC, Kim, C, Hwang, ES, Keefe, FJ, and Shelby, RA. "Imaging-Guided Core-Needle Breast Biopsy: Impact of Meditation and Music Interventions on Patient Anxiety, Pain, and Fatigue." Journal of the American College of Radiology : JACR 13.5 (May 2016): 526-534.
PMID
26853501
Source
epmc
Published In
Journal of the American College of Radiology
Volume
13
Issue
5
Publish Date
2016
Start Page
526
End Page
534
DOI
10.1016/j.jacr.2015.12.004

A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain.

Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth) technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST) intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N = 30) to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad). This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p's < 0.05). These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.

Authors
Somers, TJ; Kelleher, SA; Westbrook, KW; Kimmick, GG; Shelby, RA; Abernethy, AP; Keefe, FJ
MLA Citation
Somers, TJ, Kelleher, SA, Westbrook, KW, Kimmick, GG, Shelby, RA, Abernethy, AP, and Keefe, FJ. "A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain." Pain research and treatment 2016 (January 2016): 2473629-.
PMID
27891252
Source
epmc
Published In
Pain Research and Treatment
Volume
2016
Publish Date
2016
Start Page
2473629

Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy.

To explore how symptoms and psychosocial factors are related to intentional and unintentional non-adherent medication taking behaviors.Included were postmenopausal women with hormone receptor positive, stage I-IIIA breast cancer, who had completed surgery, chemotherapy, and radiation, and were taking endocrine therapy. Self-administered, standardized measures were completed during a routine clinic visit: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Functional Assessment of Cancer Therapy General and Neurotoxicity scales, and Self-Efficacy for Appropriate Medication Use Scale. Regression analyses were performed to determine the degree to which demographic, medical, symptom, and psychosocial variables, explain intentional, such as changing one's doses or stopping medication, and unintentional, such as forgetting to take one's medication, non-adherent behaviors.Participants were 112 women: mean age 64 (SD = 9) years; 81% white; mean time from surgery 40 (SD = 28) months; 49% received chemotherapy (39% including a taxane); mean time on endocrine therapy, 35 (SD = 29.6) months; 82% taking an aromatase inhibitor. Intentional and unintentional non-adherent behaviors were described in 33.9% and 58.9% of participants, respectively. Multivariate analysis showed that higher self-efficacy for taking medication was associated with lower levels of unintentional (p = 0.002) and intentional (p = 0.004) non-adherent behaviors. The presence of symptoms (p = 0.03) and lower self-efficacy for physician communication (p = 0.009) were associated with higher levels of intentional non-adherent behaviors.These results suggest that women who report greater symptoms, lower self-efficacy for communicating with their physician, and lower self-efficacy for taking their medication are more likely to engage in both intentional and unintentional non-adherent behaviors.

Authors
Kimmick, G; Edmond, SN; Bosworth, HB; Peppercorn, J; Marcom, PK; Blackwell, K; Keefe, FJ; Shelby, RA
MLA Citation
Kimmick, G, Edmond, SN, Bosworth, HB, Peppercorn, J, Marcom, PK, Blackwell, K, Keefe, FJ, and Shelby, RA. "Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy." Breast (Edinburgh, Scotland) 24.5 (October 2015): 630-636.
PMID
26189978
Source
epmc
Published In
The Breast
Volume
24
Issue
5
Publish Date
2015
Start Page
630
End Page
636
DOI
10.1016/j.breast.2015.06.010

Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors.

This study investigated how time from breast biopsy recommendation to biopsy procedure affected pre-biopsy anxiety (N = 140 women), and whether the relationship between wait time and anxiety was affected by psychosocial factors (chronic life stress, traumatic events, social support). Analyses showed a significant interaction between wait time and chronic life stress. Increased time from biopsy recommendation was associated with greater anxiety in women with low levels of life stress. Women with high levels of life stress experienced increased anxiety regardless of wait time. These results suggest that women may benefit from shorter wait times and receiving strategies for managing anxiety.

Authors
Hayes Balmadrid, MA; Shelby, RA; Wren, AA; Miller, LS; Yoon, SC; Baker, JA; Wildermann, LA; Soo, MS
MLA Citation
Hayes Balmadrid, MA, Shelby, RA, Wren, AA, Miller, LS, Yoon, SC, Baker, JA, Wildermann, LA, and Soo, MS. "Anxiety prior to breast biopsy: Relationships with length of time from breast biopsy recommendation to biopsy procedure and psychosocial factors." Journal of health psychology (September 30, 2015).
PMID
26424811
Source
epmc
Published In
Journal of Health Psychology
Publish Date
2015

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

Grip strength and timed get-up-and-go: Associations with symptoms among women taking adjuvant endocrine therapy.

Authors
Sitlinger, AP; Shelby, RA; White, HK; Edmond, SN; Bosworth, HB; Keefe, FJ; Kimmick, GG
MLA Citation
Sitlinger, AP, Shelby, RA, White, HK, Edmond, SN, Bosworth, HB, Keefe, FJ, and Kimmick, GG. "Grip strength and timed get-up-and-go: Associations with symptoms among women taking adjuvant endocrine therapy." May 20, 2015.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
33
Issue
15
Publish Date
2015

Adherence to adjuvant endocrine therapy for breast cancer: importance in women with low income.

There are wide disparities in breast cancer-specific survival by patient sociodemographic characteristics. Women of lower income, for instance, have higher relapse and death rates from breast cancer. One possible contributing factor for this disparity is low use of adjuvant endocrine therapy-an extremely efficacious therapy in women with early stage, hormone receptor positive breast cancer, the most common subtype of breast cancer. Alone, adjuvant endocrine therapy decreases breast cancer recurrence by 50% and death by 30%. Data suggest that low use of adjuvant endocrine therapy is a potentially important and modifiable risk factor for poor outcome in low-income breast cancer patients.

Authors
Ursem, CJ; Bosworth, HB; Shelby, RA; Hwang, W; Anderson, RT; Kimmick, GG
MLA Citation
Ursem, CJ, Bosworth, HB, Shelby, RA, Hwang, W, Anderson, RT, and Kimmick, GG. "Adherence to adjuvant endocrine therapy for breast cancer: importance in women with low income." Journal of women's health (2002) 24.5 (May 2015): 403-408. (Review)
PMID
25884292
Source
epmc
Published In
Journal of Women's Health
Volume
24
Issue
5
Publish Date
2015
Start Page
403
End Page
408
DOI
10.1089/jwh.2014.4982

A HYBRID IN-PERSON AND MHEALTH PAIN COPING SKILLS INTERVENTION FOR STEM CELL TRANSPLANT PATIENTS

Authors
Kelleher, SA; Fisher, HM; Shelby, RA; Sullivan, KM; Abernethy, AP; Keefe, FJ; Somers, TJ
MLA Citation
Kelleher, SA, Fisher, HM, Shelby, RA, Sullivan, KM, Abernethy, AP, Keefe, FJ, and Somers, TJ. "A HYBRID IN-PERSON AND MHEALTH PAIN COPING SKILLS INTERVENTION FOR STEM CELL TRANSPLANT PATIENTS." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S216-S216.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S216
End Page
S216

ANXIETY AND NEGATIVE MOOD FOLLOWING MAMMOGRAPHY SCREENING FOR BREAST CANCER

Authors
Edmond, SN; Shelby, RA; Keefe, FJ; Soo, MS; Skinner, CS; Ahrendt, G; Manculich, J; Sumkin, JH; Zuley, M; Bovbjerg, DH
MLA Citation
Edmond, SN, Shelby, RA, Keefe, FJ, Soo, MS, Skinner, CS, Ahrendt, G, Manculich, J, Sumkin, JH, Zuley, M, and Bovbjerg, DH. "ANXIETY AND NEGATIVE MOOD FOLLOWING MAMMOGRAPHY SCREENING FOR BREAST CANCER." ANNALS OF BEHAVIORAL MEDICINE 49 (April 2015): S6-S6.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
49
Publish Date
2015
Start Page
S6
End Page
S6

Dissemination of an evidence-based treatment for cancer patients: training is the necessary first step.

Evidence-based psychological treatments (EBTs) for cancer patients have not been disseminated in part due to lack of available training. The biobehavioral intervention (BBI) is an EBT designed to alleviate cancer stress and enhance coping. The current study evaluates a training program and uses the Theory of Planned Behavior (TpB) to analyze factors related to intentions to implement BBI. Mental health providers (n = 62) attended a training for BBI. Attendees' supervisors (n = 40) were later surveyed. Repeated measure ANOVAs assessed change over time in knowledge gains, attitudes towards EBTs/BBI, and self-efficacy. Linear multiple regression analyses assessed relationships between these factors and implementation intentions. BBI knowledge and attitude scores increased from pre- to post-training (ps < 0.01). Significant predictors in the final model were BBI-specific attitudes and self-efficacy (ps < 0.05). The BBI training program was an effective dissemination vehicle. Intervention-specific attitudes and self-efficacy were key factors in predicting providers' implementation intentions.

Authors
Brothers, BM; Carpenter, KM; Shelby, RA; Thornton, LM; Frierson, GM; Patterson, KL; Andersen, BL
MLA Citation
Brothers, BM, Carpenter, KM, Shelby, RA, Thornton, LM, Frierson, GM, Patterson, KL, and Andersen, BL. "Dissemination of an evidence-based treatment for cancer patients: training is the necessary first step." Translational behavioral medicine 5.1 (March 2015): 103-112.
PMID
25729459
Source
epmc
Published In
Translational Behavioral Medicine
Volume
5
Issue
1
Publish Date
2015
Start Page
103
End Page
112
DOI
10.1007/s13142-014-0273-0

Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy.

PURPOSE: This study examined the relationships between physical symptoms, self-efficacy for coping with symptoms, and functional, emotional, and social well-being in women who were taking adjuvant endocrine therapy for breast cancer. METHODS: One hundred and twelve women who were taking adjuvant endocrine therapy (tamoxifen or an aromatase inhibitor) for breast cancer completed measures of physical symptoms, self-efficacy for coping with symptoms, and functional, social, and emotional well-being at the time of routine medical follow-up (women were on average 3.4 years post-surgery; range 3 months to 11 years). RESULTS: Multiple linear regression analyses showed that higher self-efficacy for coping with symptoms was associated with greater functional, emotional, and social well-being after controlling for physical symptoms (p < 0.05). Self-efficacy for coping with symptoms moderated the relationship between physical symptoms and functional (B = 0.05, SE = 0.02, t = 2.67, p = 0.009) and emotional well-being (B = 0.03, SE = 0.01, t = 2.45, p = 0.02). As self-efficacy increased, the relationship between greater physical symptoms and lower well-being became weaker. Among women with high levels of self-efficacy, physical symptoms were not related to functional and emotional well-being. CONCLUSIONS: Self-efficacy for coping with symptoms may reduce the negative impact of physical symptoms and contribute to well-being in breast cancer survivors taking adjuvant endocrine therapy. Future studies could examine whether psychosocial interventions aimed at increasing self-efficacy for managing symptoms help women better cope with treatment side effects and improve quality of life.

Authors
Shelby, RA; Edmond, SN; Wren, AA; Keefe, FJ; Peppercorn, JM; Marcom, PK; Blackwell, KL; Kimmick, GG
MLA Citation
Shelby, RA, Edmond, SN, Wren, AA, Keefe, FJ, Peppercorn, JM, Marcom, PK, Blackwell, KL, and Kimmick, GG. "Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 22.10 (October 2014): 2851-2859.
PMID
24821365
Source
epmc
Published In
Supportive Care in Cancer
Volume
22
Issue
10
Publish Date
2014
Start Page
2851
End Page
2859
DOI
10.1007/s00520-014-2269-1

Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation.

CONTEXT: Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. OBJECTIVES: The purpose of the present study was to assess the moderating effects of holding back discussion of disease-related concerns on the relationship between health-related symptoms and social well-being in adult patients undergoing HSCT. METHODS: Seventy autologous (n = 55) and allogeneic (n = 15) HSCT patients completed measures of holding back, social well-being, and health symptoms (i.e., pain, fatigue, sleep problems, cognitive problems) both before and after transplantation (i.e., three months after transplantation and six months after transplantation). RESULTS: In patients with average to high levels of holding back, health symptoms were significantly related to lower levels of social well-being; however, for patients with low levels of holding back, the relationship between health symptoms and social well-being was not significant. CONCLUSION: The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.

Authors
Bartley, EJ; Edmond, SN; Wren, AA; Somers, TJ; Teo, I; Zhou, S; Rowe, KA; Abernethy, AP; Keefe, FJ; Shelby, RA
MLA Citation
Bartley, EJ, Edmond, SN, Wren, AA, Somers, TJ, Teo, I, Zhou, S, Rowe, KA, Abernethy, AP, Keefe, FJ, and Shelby, RA. "Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation." Journal of pain and symptom management 48.3 (September 2014): 374-384.
PMID
24529631
Source
epmc
Published In
Journal of Pain and Symptom Management
Volume
48
Issue
3
Publish Date
2014
Start Page
374
End Page
384
DOI
10.1016/j.jpainsymman.2013.09.019

Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function.

There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy.This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy.We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System(®) (PROMIS(®) ) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy.In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item.Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension.Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development.

Authors
Alexander, AM; Flynn, KE; Hahn, EA; Jeffery, DD; Keefe, FJ; Reeve, BB; Schultz, W; Reese, JB; Shelby, RA; Weinfurt, KP
MLA Citation
Alexander, AM, Flynn, KE, Hahn, EA, Jeffery, DD, Keefe, FJ, Reeve, BB, Schultz, W, Reese, JB, Shelby, RA, and Weinfurt, KP. "Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function." The journal of sexual medicine 11.8 (August 2014): 1991-1998.
PMID
24902984
Source
epmc
Published In
The Journal of Sexual Medicine
Volume
11
Issue
8
Publish Date
2014
Start Page
1991
End Page
1998
DOI
10.1111/jsm.12599

Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies.

PURPOSE: The purpose of this study was to evaluate pain experienced during imaging-guided core-needle breast biopsies and to identify factors that predict increased pain perception during procedures. METHODS: In this institutional review board-approved, HIPAA-compliant protocol, 136 women undergoing stereotactically or ultrasound-guided breast biopsy or cyst aspiration were recruited and provided written informed consent. Participants filled out questionnaires assessing anticipated biopsy pain, ongoing breast pain, pain experienced during biopsy, catastrophic thoughts about pain during biopsy, anxiety, perceived communication with the radiologist, chronic life stress, and demographic and medical information. Procedure type, experience level of the radiologist performing the biopsy, number of biopsies, breast density, histology, and tumor size were recorded for each patient. Data were analyzed using Spearman's ρ correlations and a probit regression model. RESULTS: No pain (0 out of 10) was reported by 39.7% of women, mild pain (1-3 out of 10) by 48.5%, and moderate to severe pain (≥4 out of 10) by 11.8% (n = 16). Significant (P < .05) predictors of greater biopsy pain in the probit regression model included younger age, greater prebiopsy breast pain, higher anticipated biopsy pain, and undergoing a stereotactic procedure. Anticipated biopsy pain correlated most strongly with biopsy pain (β = .27, P = .004). CONCLUSIONS: Most patients report minimal pain during imaging-guided biopsy procedures. Women experiencing greater pain levels tended to report higher anticipated pain before the procedure. Communication with patients before biopsy regarding minimal average pain reported during biopsy and encouragement to make use of coping strategies may reduce patient anxiety and anticipated pain.

Authors
Soo, AE; Shelby, RA; Miller, LS; Balmadrid, MH; Johnson, KS; Wren, AA; Yoon, SC; Keefe, FJ; Soo, MS
MLA Citation
Soo, AE, Shelby, RA, Miller, LS, Balmadrid, MH, Johnson, KS, Wren, AA, Yoon, SC, Keefe, FJ, and Soo, MS. "Predictors of pain experienced by women during percutaneous imaging-guided breast biopsies." Journal of the American College of Radiology : JACR 11.7 (July 2014): 709-716.
PMID
24993536
Source
epmc
Published In
Journal of the American College of Radiology
Volume
11
Issue
7
Publish Date
2014
Start Page
709
End Page
716
DOI
10.1016/j.jacr.2014.01.013

Persistent pain following breast cancer surgery: A case-control study.

Authors
Edmond, SN; Shelby, RA; Keefe, FJ; Soo, MS; Skinner, CS; Stinnett, S; Ahrendt, GM; Manculich, J; Sumkin, JH; Zuley, ML; Bovbjerg, DH
MLA Citation
Edmond, SN, Shelby, RA, Keefe, FJ, Soo, MS, Skinner, CS, Stinnett, S, Ahrendt, GM, Manculich, J, Sumkin, JH, Zuley, ML, and Bovbjerg, DH. "Persistent pain following breast cancer surgery: A case-control study." May 20, 2014.
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
32
Issue
15
Publish Date
2014

IMPACT OF EXPERIENCES AT THE TIME OF BREAST BIOPSY ON KNOWLEDGE OF RECOMMENDED FOLLOW-UP, PERCEIVED CANCER RISK, BELIEFS ABOUT MAMMOGRAPHY, AND PREFERENCES FOR SUPPORT

Authors
Huysmans, ZZ; Wren, AA; Shelby, RA; Keefe, FJ; Soo, MS
MLA Citation
Huysmans, ZZ, Wren, AA, Shelby, RA, Keefe, FJ, and Soo, MS. "IMPACT OF EXPERIENCES AT THE TIME OF BREAST BIOPSY ON KNOWLEDGE OF RECOMMENDED FOLLOW-UP, PERCEIVED CANCER RISK, BELIEFS ABOUT MAMMOGRAPHY, AND PREFERENCES FOR SUPPORT." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S190-S190.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S190
End Page
S190

PERSISTENT POST-SURGICAL PAIN FOLLOWING BREAST CONSERVING SURGERY: LEVELS OF PAIN AND PSYCHOSOCIAL FACTORS

Authors
Shelby, RA; Edmond, SN; Soo, MS; Keefe, FJ; Ahrendt, GM; Sumkin, J; Zuley, M; Bovbjerg, DH
MLA Citation
Shelby, RA, Edmond, SN, Soo, MS, Keefe, FJ, Ahrendt, GM, Sumkin, J, Zuley, M, and Bovbjerg, DH. "PERSISTENT POST-SURGICAL PAIN FOLLOWING BREAST CONSERVING SURGERY: LEVELS OF PAIN AND PSYCHOSOCIAL FACTORS." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S189-S189.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S189
End Page
S189

DISSEMINATION OF THE BIOBEHAVIORAL INTERVENTION: FROM CANCER TO HEALTH

Authors
Dorfman, CS; Brothers, BM; Carpenter, KM; Frierson, GM; Shelby, RA; Thornton, LM; Andersen, BL
MLA Citation
Dorfman, CS, Brothers, BM, Carpenter, KM, Frierson, GM, Shelby, RA, Thornton, LM, and Andersen, BL. "DISSEMINATION OF THE BIOBEHAVIORAL INTERVENTION: FROM CANCER TO HEALTH." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S166-S166.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S166
End Page
S166

COGNITIVE PROBLEMS IN SCT PATIENTS THREE MONTHS POST-TRANSPLANT: ASSOCIATED PSYCHOSOCIAL FACTORS

Authors
Edmond, SN; O'Sullivan, ML; Somers, TJ; Rowe, K; Shelby, RA
MLA Citation
Edmond, SN, O'Sullivan, ML, Somers, TJ, Rowe, K, and Shelby, RA. "COGNITIVE PROBLEMS IN SCT PATIENTS THREE MONTHS POST-TRANSPLANT: ASSOCIATED PSYCHOSOCIAL FACTORS." ANNALS OF BEHAVIORAL MEDICINE 47 (April 2014): S102-S102.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
47
Publish Date
2014
Start Page
S102
End Page
S102

Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function

Introduction: There is a significant gap in research regarding the readability and comprehension of existing sexual function measures. Patient-reported outcome measures may use terms not well understood by respondents with low literacy. Aim: This study aims to test comprehension of words and phrases typically used in sexual function measures to improve validity for all individuals, including those with low literacy. Methods: We recruited 20 men and 28 women for cognitive interviews on version 2.0 of the Patient-Reported Outcome Measurement Information System® (PROMIS®) Sexual Function and Satisfaction measures. We assessed participants' reading level using the word reading subtest of the Wide Range Achievement Test. Sixteen participants were classified as having low literacy. Main Outcome Measures: In the first round of cognitive interviews, each survey item was reviewed by five or more people, at least two of whom had lower than a ninth-grade reading level (low literacy). Patient feedback was incorporated into a revised version of the items. In the second round of interviews, an additional three or more people (at least one with low literacy) reviewed each revised item. Results: Participants with low literacy had difficulty comprehending terms such as aroused, orgasm, erection, ejaculation, incontinence, and vaginal penetration. Women across a range of literacy levels had difficulty with clinical terms like labia and clitoris. We modified unclear terms to include parenthetical descriptors or slang equivalents, which generally improved comprehension. Conclusions: Common words and phrases used across measures of self-reported sexual function are not universally understood. Researchers should appreciate these misunderstandings as a potential source of error in studies using self-reported measures of sexual function. This study also provides evidence for the importance of including individuals with low literacy in cognitive pretesting during the measure development. Alexander AM, Flynn KE, Hahn EA, Jeffery DD, Keefe FJ, Reeve BB, Schultz W, Reese JB, Shelby RA, and Weinfurt KP. Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function. J Sex Med 2014;11:1991-1998. © 2014 International Society for Sexual Medicine.

Authors
Alexander, AM; Flynn, KE; Hahn, EA; Jeffery, DD; Keefe, FJ; Reeve, BB; Schultz, W; Reese, JB; Shelby, RA; Weinfurt, KP
MLA Citation
Alexander, AM, Flynn, KE, Hahn, EA, Jeffery, DD, Keefe, FJ, Reeve, BB, Schultz, W, Reese, JB, Shelby, RA, and Weinfurt, KP. "Improving patients' understanding of terms and phrases commonly used in self-reported measures of sexual function." Journal of Sexual Medicine 11.8 (January 1, 2014): 1991-1998.
Source
scopus
Published In
The Journal of Sexual Medicine
Volume
11
Issue
8
Publish Date
2014
Start Page
1991
End Page
1998
DOI
10.1111/jsm.12599

Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation

© 2014 American Academy of Hospice and Palliative Medicine.Context. Holding back, or withholding discussion of disease-related thoughts and emotions, is associated with negative outcomes including lower quality of life, diminished well-being, and relational distress. For patients undergoing hematopoietic stem cell transplantation (HSCT), the degree to which one holds back from discussing illness-related concerns may be an important determinant of social well-being and health; however, this has not been systematically assessed in this population. Objectives. The purpose of the present study was to assess the moderating effects of holding back discussion of disease-related concerns on the relationship between health-related symptoms and social well-being in adult patients undergoing HSCT. Methods. Seventy autologous (n = 55) and allogeneic (n = 15) HSCT patients completed measures of holding back, social well-being, and health symptoms (i.e., pain, fatigue, sleep problems, cognitive problems) both before and after transplantation (i.e., three months after transplantation and six months after transplantation). Results. In patients with average to high levels of holding back, health symptoms were significantly related to lower levels of social well-being; however, for patients with low levels of holding back, the relationship between health symptoms and social well-being was not significant. Conclusion. The results of the present study suggest that the level of holding back may be important in understanding how health-related symptoms relate to social well-being in patients undergoing HSCT. These findings underscore the importance of addressing how patients undergoing HSCT communicate about their disease with others as this may be related to their adjustment to illness and treatment.

Authors
Bartley, EJ; Edmond, SN; Wren, AA; Somers, TJ; Teo, I; Zhou, S; Rowe, KA; Abernethy, AP; Keefe, FJ; Shelby, RA
MLA Citation
Bartley, EJ, Edmond, SN, Wren, AA, Somers, TJ, Teo, I, Zhou, S, Rowe, KA, Abernethy, AP, Keefe, FJ, and Shelby, RA. "Holding back moderates the association between health symptoms and social well-being in patients undergoing hematopoietic stem cell transplantation." Journal of Pain and Symptom Management 48.3 (January 1, 2014): 374-384.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
48
Issue
3
Publish Date
2014
Start Page
374
End Page
384
DOI
10.1016/j.jpainsymman.2013.09.019

Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy

© 2014, Springer-Verlag Berlin Heidelberg.Purpose: This study examined the relationships between physical symptoms, self-efficacy for coping with symptoms, and functional, emotional, and social well-being in women who were taking adjuvant endocrine therapy for breast cancer.Methods: One hundred and twelve women who were taking adjuvant endocrine therapy (tamoxifen or an aromatase inhibitor) for breast cancer completed measures of physical symptoms, self-efficacy for coping with symptoms, and functional, social, and emotional well-being at the time of routine medical follow-up (women were on average 3.4 years post-surgery; range 3 months to 11 years).Results: Multiple linear regression analyses showed that higher self-efficacy for coping with symptoms was associated with greater functional, emotional, and social well-being after controlling for physical symptoms (p < 0.05). Self-efficacy for coping with symptoms moderated the relationship between physical symptoms and functional (B = 0.05, SE = 0.02, t = 2.67, p = 0.009) and emotional well-being (B = 0.03, SE = 0.01, t = 2.45, p = 0.02). As self-efficacy increased, the relationship between greater physical symptoms and lower well-being became weaker. Among women with high levels of self-efficacy, physical symptoms were not related to functional and emotional well-being.Conclusions: Self-efficacy for coping with symptoms may reduce the negative impact of physical symptoms and contribute to well-being in breast cancer survivors taking adjuvant endocrine therapy. Future studies could examine whether psychosocial interventions aimed at increasing self-efficacy for managing symptoms help women better cope with treatment side effects and improve quality of life.

Authors
Shelby, RA; Edmond, SN; Wren, AA; Keefe, FJ; Peppercorn, JM; Marcom, PK; Blackwell, KL; Kimmick, GG
MLA Citation
Shelby, RA, Edmond, SN, Wren, AA, Keefe, FJ, Peppercorn, JM, Marcom, PK, Blackwell, KL, and Kimmick, GG. "Self-efficacy for coping with symptoms moderates the relationship between physical symptoms and well-being in breast cancer survivors taking adjuvant endocrine therapy." Supportive Care in Cancer 22.10 (2014): 2851-2859.
Source
scival
Published In
Supportive Care in Cancer
Volume
22
Issue
10
Publish Date
2014
Start Page
2851
End Page
2859
DOI
10.1007/s00520-014-2269-1

Targeted investment improves access to hospice and palliative care

Context: Availability of hospice and palliative care is increasing, despite lack of a clear national strategy for developing and evaluating their penetration into and impact on the target population. Objectives: To determine whether targeted investment (i.e., strategic grants made by one charitable foundation) in hospice and palliative care in one U.S. state (North Carolina [NC]) led to improved access to end-of-life care services as indicated by hospice utilization. Methods: Access was measured by the death service ratio (DSR), defined as the proportion of people who died and were served by hospice for at least one day before death. Calculation of the DSR is based on counts of patients accessing hospice by county in a given year (numerator) and U.S. Census projected population data for that county (denominator). Multilevel modeling was the primary analytic strategy used to generate two models: 1) comparison of the DSR in counties with vs. without philanthropic funding and 2) relationship between years since receipt of a philanthropic grant and DSR. Results: In NC, the average DSR increased from 20.7% in 2003 to 35.8% in 2009 (55% increase). In 2009, 82 of 100 NC counties had a DSR below the U.S. average (41.6%). In Model 1, significant associations were found between county population and DSR (P = 0.03) and between receipt of philanthropic funding and DSR (P = 0.01); on average, funded counties had a DSR that was 2.63 percentage points higher than unfunded counties. Conclusion: Receipt of philanthropic funding appeared to be associated with improved access to palliative care and hospice services in NC. © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Authors
Abernethy, AP; Bull, J; Whitten, E; Shelby, R; Wheeler, JL; Taylor, DH
MLA Citation
Abernethy, AP, Bull, J, Whitten, E, Shelby, R, Wheeler, JL, and Taylor, DH. "Targeted investment improves access to hospice and palliative care." Journal of Pain and Symptom Management 46.5 (November 1, 2013): 629-639.
Source
scopus
Published In
Journal of Pain and Symptom Management
Volume
46
Issue
5
Publish Date
2013
Start Page
629
End Page
639
DOI
10.1016/j.jpainsymman.2012.12.012

Targeted investment improves access to hospice and palliative care.

CONTEXT: Availability of hospice and palliative care is increasing, despite lack of a clear national strategy for developing and evaluating their penetration into and impact on the target population. OBJECTIVES: To determine whether targeted investment (i.e., strategic grants made by one charitable foundation) in hospice and palliative care in one U.S. state (North Carolina [NC]) led to improved access to end-of-life care services as indicated by hospice utilization. METHODS: Access was measured by the death service ratio (DSR), defined as the proportion of people who died and were served by hospice for at least one day before death. Calculation of the DSR is based on counts of patients accessing hospice by county in a given year (numerator) and U.S. Census projected population data for that county (denominator). Multilevel modeling was the primary analytic strategy used to generate two models: 1) comparison of the DSR in counties with vs. without philanthropic funding and 2) relationship between years since receipt of a philanthropic grant and DSR. RESULTS: In NC, the average DSR increased from 20.7% in 2003 to 35.8% in 2009 (55% increase). In 2009, 82 of 100 NC counties had a DSR below the U.S. average (41.6%). In Model 1, significant associations were found between county population and DSR (P=0.03) and between receipt of philanthropic funding and DSR (P=0.01); on average, funded counties had a DSR that was 2.63 percentage points higher than unfunded counties. CONCLUSION: Receipt of philanthropic funding appeared to be associated with improved access to palliative care and hospice services in NC.

Authors
Abernethy, AP; Bull, J; Whitten, E; Shelby, R; Wheeler, JL; Taylor, DH
MLA Citation
Abernethy, AP, Bull, J, Whitten, E, Shelby, R, Wheeler, JL, and Taylor, DH. "Targeted investment improves access to hospice and palliative care." J Pain Symptom Manage 46.5 (November 2013): 629-639.
PMID
23669467
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
46
Issue
5
Publish Date
2013
Start Page
629
End Page
639
DOI
10.1016/j.jpainsymman.2012.12.012

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

Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication

Purpose: The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy. Methods: After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses. Results: Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P = .01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P < .001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P = .04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists. Conclusions: Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening. © 2013 American College of Radiology.

Authors
Miller, LS; Shelby, RA; Balmadrid, MH; Yoon, S; Baker, JA; Wildermann, L; Soo, MS
MLA Citation
Miller, LS, Shelby, RA, Balmadrid, MH, Yoon, S, Baker, JA, Wildermann, L, and Soo, MS. "Patient Anxiety Before and Immediately After Imaging-Guided Breast Biopsy Procedures: Impact of Radiologist-Patient Communication." JACR Journal of the American College of Radiology (2013).
PMID
23499400
Source
scival
Published In
Journal of the American College of Radiology
Publish Date
2013
DOI
10.1016/j.jacr.2012.11.005

Patient anxiety before and immediately after imaging-guided breast biopsy procedures: Impact of radiologist-patient communication

Purpose: The aim of this study was to evaluate patient anxiety and its association with perceived radiologist-patient communication in the setting of imaging-guided breast biopsy. Methods: After informed consent was obtained, 138 women recommended for imaging-guided breast procedures completed questionnaires immediately before and after biopsies, measuring state anxiety using the State-Trait Anxiety Inventory (range, 20-80). Before biopsies, women also completed questionnaires regarding their perceived communication with the radiologists recommending the procedures (modified Questionnaire on the Quality of Physician-Patient Interaction), demographic characteristics, and medical history; immediately after the biopsies, they completed a measure of perceived communication with the radiologists performing the biopsies. Experience levels (eg, attending radiologist, fellow) of the radiologists recommending and performing the biopsies were recorded. Data were analyzed using paired and independent t tests, one-way analysis of variance, Pearson's correlations, and multiple linear regression analyses. Results: Average prebiopsy anxiety was 44.5 ± 12.4 (range, 20-77) on a scale ranging from 20 to 80 points. Perceived communication with radiologists recommending biopsies averaged 52.4 ± 11.5 (range, 18-65). Better communication with radiologists recommending biopsies was significantly associated with lower levels of prebiopsy anxiety (r = -0.22, P =.01). After the biopsies, women's anxiety significantly decreased (paired t = -7.32, P <.001). Better communication with radiologists performing biopsies (mean, 57.8 ± 8.4; range, 32-65) was associated with lower postbiopsy anxiety after accounting for patients' baseline anxiety levels (β = -0.17, P =.04). White women reported higher prebiopsy and postbiopsy anxiety; nonwhite women reported poorer communication with recommending radiologists. Conclusions: Patients' perceptions of better communication with radiologists were associated with lower levels of anxiety before and after biopsies. These results have implications for radiologist training and adherence to mammographic screening. © 2013 American College of Radiology.

Authors
Miller, LS; Shelby, RA; Balmadrid, MH; Yoon, S; Baker, JA; Wildermann, L; Soo, MS
MLA Citation
Miller, LS, Shelby, RA, Balmadrid, MH, Yoon, S, Baker, JA, Wildermann, L, and Soo, MS. "Patient anxiety before and immediately after imaging-guided breast biopsy procedures: Impact of radiologist-patient communication." Journal of the American College of Radiology 10.6 (2013): 423-431.
Source
scival
Published In
Journal of the American College of Radiology
Volume
10
Issue
6
Publish Date
2013
Start Page
423
End Page
431
DOI
10.1016/j.jacr.2012.11.005

Symptom communication in breast cancer: relationships of holding back and self-efficacy for communication to symptoms and adjustment.

Adjuvant endocrine therapy improves overall survival for women with breast cancer. However, side effects may compromise patients' quality of life (QOL). This study examined how two communication variables (self-efficacy for symptom communication [SE] and holding back from discussing cancer-related concerns [HB]) relate to QOL, pain and menopausal symptoms. Participants with breast cancer (N = 61) completed questionnaires regarding symptoms, communication, and QOL. SE was positively related to QOL and negatively related to pain interference. HB from discussing cancer-related concerns was related negatively to QOL and positively to pain interference. HB mediated the relationship between SE and QOL as well as between SE and pain interference. Increased SE is beneficial among women on endocrine therapy for breast cancer. Future research should determine if interventions to improve SE are feasible and can improve QOL and symptom tolerability.

Authors
Edmond, SN; Shelby, RA; Kimmick, GG; Marcom, PK; Peppercorn, JM; Keefe, FJ
MLA Citation
Edmond, SN, Shelby, RA, Kimmick, GG, Marcom, PK, Peppercorn, JM, and Keefe, FJ. "Symptom communication in breast cancer: relationships of holding back and self-efficacy for communication to symptoms and adjustment." J Psychosoc Oncol 31.6 (2013): 698-711.
PMID
24175903
Source
pubmed
Published In
Journal of Psychosocial Oncology
Volume
31
Issue
6
Publish Date
2013
Start Page
698
End Page
711
DOI
10.1080/07347332.2013.835023

The context of pain in arthritis: self-efficacy for managing pain and other symptoms.

Arthritis pain may be best understood in the context of a biospychosocial model of pain. The biopsychosocial model of pain suggests that adjustment to arthritis pain is multifaceted and is influenced by biological, psychological, and social factors. One psychological construct that appears to be particularly helpful in understanding arthritis pain is patients' self-efficacy for managing pain and other symptoms. In recent work, investigators have included self-efficacy for managing pain and other symptoms as key outcome measures in behavioral and psychosocial intervention studies. The goal of this article was to review recent intervention studies that have examined the effect of behavioral and psychosocial interventions on self-efficacy for managing pain and other symptoms. Throughout the article, we make several suggestions for future clinical and research considerations regarding the role of self-efficacy for managing pain and other symptoms in the context of arthritis pain.

Authors
Somers, TJ; Wren, AA; Shelby, RA
MLA Citation
Somers, TJ, Wren, AA, and Shelby, RA. "The context of pain in arthritis: self-efficacy for managing pain and other symptoms." Curr Pain Headache Rep 16.6 (December 2012): 502-508. (Review)
PMID
23054977
Source
pubmed
Published In
Current Pain and Headache Reports
Volume
16
Issue
6
Publish Date
2012
Start Page
502
End Page
508
DOI
10.1007/s11916-012-0298-3

Assessment of the psychometric properties of an English version of the cancer dyspnea scale in people with advanced lung cancer.

CONTEXT: Dyspnea is a poorly understood subjective sensation. Existing dyspnea measures fail to adequately address its multidimensionality. A Japanese group developed and validated the Cancer Dyspnea Scale (CDS) for assessing dyspnea in patients with advanced lung cancer. OBJECTIVES: We evaluated the validity and reliability of the English version of the CDS (CDS-E) that has 12 items and takes, on average, 140 seconds for individuals to complete. METHODS: Eligible patients had advanced lung cancer, consented, and were fluent in English. Participants completed a 100 mm visual analogue scale (VAS), the modified Borg scale, the CDS-E, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy--Lung quality-of-life scale. Demographic, radiographic, and treatment information were obtained from patients' medical records. RESULTS: One hundred twelve participants were enrolled at three sites in the U.S., Australia, and the U.K. Mean age was 64.5 years (SD 11.5); 90% were Caucasian, 68% had Eastern Cooperative Oncology Group performance status 0-1, and 50% had non-small cell carcinoma. All completed the CDS-E independently, without difficulty. The CDS-E had reasonable internal consistency overall (Cronbach's α = 0.71) and for each of the three factors (effort, anxiety, discomfort Cronbach's α = 0.80-0.84). CDS-E scores were significantly correlated with the 100mm VAS (r = 0.82; P < 0.001) and the modified Borg (r = 0.87; P < 0.001). After factor analysis, the CDS-E was revised by removing three items (r-CDS-E). CONCLUSION: The CDS-E and r-CDS-E are reliable and valid measures of the sensation and the psychological components of dyspnea, with the shorter version having similar psychometric properties.

Authors
Uronis, HE; Shelby, RA; Currow, DC; Ahmedzai, SH; Bosworth, HB; Coan, A; Abernethy, AP
MLA Citation
Uronis, HE, Shelby, RA, Currow, DC, Ahmedzai, SH, Bosworth, HB, Coan, A, and Abernethy, AP. "Assessment of the psychometric properties of an English version of the cancer dyspnea scale in people with advanced lung cancer." J Pain Symptom Manage 44.5 (November 2012): 741-749.
PMID
22765966
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
44
Issue
5
Publish Date
2012
Start Page
741
End Page
749
DOI
10.1016/j.jpainsymman.2011.10.027

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

Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study.

Overweight and obese patients with osteoarthritis (OA) experience more OA pain and disability than patients who are not overweight. This study examined the long-term efficacy of a combined pain coping skills training (PCST) and lifestyle behavioral weight management (BWM) intervention in overweight and obese OA patients. Patients (n=232) were randomized to a 6-month program of: 1) PCST+BWM; 2) PCST-only; 3) BWM-only; or 4) standard care control. Assessments of pain, physical disability (Arthritis Impact Measurement Scales [AIMS] physical disability, stiffness, activity, and gait), psychological disability (AIMS psychological disability, pain catastrophizing, arthritis self-efficacy, weight self-efficacy), and body weight were collected at 4 time points (pretreatment, posttreatment, and 6 months and 12 months after the completion of treatment). Patients randomized to PCST+BWM demonstrated significantly better treatment outcomes (average of all 3 posttreatment values) in terms of pain, physical disability, stiffness, activity, weight self-efficacy, and weight when compared to the other 3 conditions (Ps<0.05). PCST+BWM also did significantly better than at least one of the other conditions (ie, PCST-only, BWM-only, or standard care) in terms of psychological disability, pain catastrophizing, and arthritis self-efficacy. Interventions teaching overweight and obese OA patients pain coping skills and weight management simultaneously may provide the more comprehensive long-term benefits.

Authors
Somers, TJ; Blumenthal, JA; Guilak, F; Kraus, VB; Schmitt, DO; Babyak, MA; Craighead, LW; Caldwell, DS; Rice, JR; McKee, DC; Shelby, RA; Campbell, LC; Pells, JJ; Sims, EL; Queen, R; Carson, JW; Connelly, M; Dixon, KE; Lacaille, LJ; Huebner, JL; Rejeski, WJ; Keefe, FJ
MLA Citation
Somers, TJ, Blumenthal, JA, Guilak, F, Kraus, VB, Schmitt, DO, Babyak, MA, Craighead, LW, Caldwell, DS, Rice, JR, McKee, DC, Shelby, RA, Campbell, LC, Pells, JJ, Sims, EL, Queen, R, Carson, JW, Connelly, M, Dixon, KE, Lacaille, LJ, Huebner, JL, Rejeski, WJ, and Keefe, FJ. "Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study." Pain 153.6 (June 2012): 1199-1209.
PMID
22503223
Source
pubmed
Published In
Pain
Volume
153
Issue
6
Publish Date
2012
Start Page
1199
End Page
1209
DOI
10.1016/j.pain.2012.02.023

Brief Fear of Movement Scale for osteoarthritis.

OBJECTIVE: Fear of movement has important clinical implications for individuals with osteoarthritis (OA). This study aimed to establish a brief fear of movement scale for use in OA. Items from the Tampa Scale for Kinesiophobia (TSK) were examined. METHODS: The English version of the TSK was examined in a community-based sample (n = 1,136) of individuals with OA of the hip or knee. Exploratory and confirmatory factor analyses were used to determine the number and content of the dimensions of fear of movement. Factorial invariance was tested across subgroups of sex, race, education, and OA severity. Convergent validity with measures of pain, physical functioning, and psychological functioning was examined. RESULTS: Factor analyses identified a single-factor 6-item scale that measures activity avoidance due to pain-related fear of movement (confirmatory factor analysis indices of model fit: root mean square error of approximation = 0.04, standardized root mean square residual = 0.01, comparative fit index = 0.99, and Tucker-Lewis Index = 0.99). The 6-item scale demonstrated factorial invariance across sex, race, levels of education, and OA severity, suggesting that this scale performs consistently across diverse groups of individuals with OA. Convergent validity with measures of pain (β = 0.30-0.41), physical functioning (β = 0.44-0.48), and psychological functioning (β = 0.36-0.37) was also demonstrated. CONCLUSION: The Brief Fear of Movement Scale identified in this study provides a promising and valid approach for assessing fear of movement in individuals with OA. This brief scale demonstrated several important strengths, including a small number of items, sound psychometric properties, and consistent performance across diverse groups of individuals with OA.

Authors
Shelby, RA; Somers, TJ; Keefe, FJ; DeVellis, BM; Patterson, C; Renner, JB; Jordan, JM
MLA Citation
Shelby, RA, Somers, TJ, Keefe, FJ, DeVellis, BM, Patterson, C, Renner, JB, and Jordan, JM. "Brief Fear of Movement Scale for osteoarthritis." Arthritis Care Res (Hoboken) 64.6 (June 2012): 862-871.
PMID
22290689
Source
pubmed
Published In
Arthritis Care and Research
Volume
64
Issue
6
Publish Date
2012
Start Page
862
End Page
871
DOI
10.1002/acr.21626

Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer.

PURPOSE: This prospective study examined the factors that predicted sustained adherence to surveillance mammography in women treated for breast cancer. METHODS: Breast cancer survivors (N = 204) who were undergoing surveillance mammography completed questionnaires assessing mammography-related anticipatory anxiety, persistent breast pain, mammography pain, and catastrophic thoughts about mammography pain. Adherence to mammography in the following year was assessed. RESULTS: In the year after study entry, 84.8% of women (n = 173) returned for a subsequent mammogram. Unadjusted associations showed that younger age, shorter period of time since surgery, and having upper extremity lymphedema were associated with lower mammography adherence. Forty percent of women reported moderate to high levels of mammography pain (score of ≥ 5 on a 0 to 10 scale). Although mammography pain was not associated with adherence, higher levels of mammography-related anxiety and pain catastrophizing were associated with not returning for a mammogram (P < .05). The impact of anxiety on mammography use was mediated by pain catastrophizing (indirect effect, P < .05). CONCLUSION: Findings suggest that women who are younger, closer to the time of surgery, or have upper extremity lymphedema may be less likely to undergo repeated mammograms. It may be important for health professionals to remind selected patients directly that some women avoid repeat mammography and to re-emphasize the value of mammography for women with a history of breast cancer. Teaching women behavioral techniques (eg, redirecting attention) or providing medication for reducing anxiety could be considered for women with high levels of anxiety or catastrophic thoughts related to mammography.

Authors
Shelby, RA; Scipio, CD; Somers, TJ; Soo, MS; Weinfurt, KP; Keefe, FJ
MLA Citation
Shelby, RA, Scipio, CD, Somers, TJ, Soo, MS, Weinfurt, KP, and Keefe, FJ. "Prospective study of factors predicting adherence to surveillance mammography in women treated for breast cancer." J Clin Oncol 30.8 (March 10, 2012): 813-819.
PMID
22331949
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
30
Issue
8
Publish Date
2012
Start Page
813
End Page
819
DOI
10.1200/JCO.2010.34.4333

Sexual quality of life in patients undergoing coronary artery bypass graft surgery

Objectives: Despite improvements in many domains of functioning, sexual quality of life often remains impaired following coronary artery bypass graft (CABG) surgery. This study examined associations among sexual quality of life, fear of sexual activity and receiving information from providers about sexual activity in CABG patients. Methods: Participants completed a survey assessing sexual activity, mental health and physical health at baseline (3-5-day post-surgery; n = 60) and 2-month post-surgery (n = 42). Results: Sexual quality of life showed moderate difficulties at baseline and did not improve by follow-up (p values ≥0.09). At follow-up, greater patient fear was associated with lower sexual quality of life in some domains; receiving information was related to lower fear (p values ≤0.03) and greater sexual satisfaction and interest (p values ≤0.04). Suggestive of mediation, there was a significant indirect effect of information on patient fear and of patient fear on sexual interest (p = 0.05). Conclusions: Though data were cross-sectional, findings suggest that fears of sexual activity may play a role in lowering CABG patients' motivation for sexual activity and that receiving information from a medical provider may assist in hastening sexual rehabilitation. Prospective and intervention studies are needed to support findings. © 2012 Copyright Taylor and Francis Group, LLC.

Authors
Reese, JB; Shelby, RA; Taylor, KL
MLA Citation
Reese, JB, Shelby, RA, and Taylor, KL. "Sexual quality of life in patients undergoing coronary artery bypass graft surgery." Psychology and Health 27.6 (2012): 721-736.
PMID
22149897
Source
scival
Published In
Psychology and Health
Volume
27
Issue
6
Publish Date
2012
Start Page
721
End Page
736
DOI
10.1080/08870446.2011.623781

Longitudinal patient-reported performance status assessment in the cancer clinic is feasible and prognostic.

PURPOSE: Performance status is prognostic in oncology and palliative care settings. Traditionally clinician rated, it is often inconsistently collected, recorded, and measured, thereby limiting its utility. Patient-reported strategies are increasingly used for routine symptom and quality of life assessment in the clinic, and may be useful for tracking performance status. METHODS: Tablet personal computers were used to collect patient-reported reviews of systems via the Patient Care Monitor (PCM) v2.0 for 86 patients with advanced lung cancer. Relevant subscales included the PCM Impaired Performance and Impaired Ambulation scales. Trained nurse clinicians measured performance status using traditional Karnofsky and Eastern Cooperative Oncology Group (ECOG) instruments. Correlation coefficients were used to compare performance status scales, and survival analysis was performed by Cox proportional hazards modeling. RESULTS: All four performance status scales demonstrated excellent internal consistency and convergent validity. Initial KPS and ECOG scores were statistically correlated with survival, whereas PCM scores showed a nonsignificant trend in this direction. Change in PCM Impaired Performance over time was statistically correlated with survival (hazard ratio = 1.62, P = .046), whereas the other three performance status measures were not statistically prognostic. CONCLUSION: Patient-reported performance status as measured by PCM v2.0 is at least as reliable as KPS or ECOG. The enhanced resolution provided by this patient-reported method allows for the detection of clinically meaningful changes in trajectory over time, potentially serving as an early-warning system to trigger clinical interventions. Further study is needed to test these findings on a larger scale.

Authors
Suh, S-Y; Leblanc, TW; Shelby, RA; Samsa, GP; Abernethy, AP
MLA Citation
Suh, S-Y, Leblanc, TW, Shelby, RA, Samsa, GP, and Abernethy, AP. "Longitudinal patient-reported performance status assessment in the cancer clinic is feasible and prognostic." J Oncol Pract 7.6 (November 2011): 374-381.
PMID
22379420
Source
pubmed
Published In
Journal of Oncology Practice
Volume
7
Issue
6
Publish Date
2011
Start Page
374
End Page
381
DOI
10.1200/JOP.2011.000434

Symptom experiences and nonadherent medication-taking behaviors of breast cancer patients taking adjuvant hormone therapy

Authors
Shelby, RA; Keefe, FJ; Red, SN; Blackwell, KL; Peppercorn, JM; Marcom, PK; Kimmick, GG
MLA Citation
Shelby, RA, Keefe, FJ, Red, SN, Blackwell, KL, Peppercorn, JM, Marcom, PK, and Kimmick, GG. "Symptom experiences and nonadherent medication-taking behaviors of breast cancer patients taking adjuvant hormone therapy." JOURNAL OF CLINICAL ONCOLOGY 29.15 (May 20, 2011).
Source
wos-lite
Published In
Journal of Clinical Oncology
Volume
29
Issue
15
Publish Date
2011

Symptom experiences and nonadherent medication-taking behaviors of breast cancer patients taking adjuvant hormone therapy.

524 Background: Many breast cancer patients do not adhere to prescribed adjuvant hormone therapy. This pilot study explored symptom experiences and medication adherence behaviors.Eligible women were postmenopausal, had hormone receptor positive stage I-IIIA breast cancer, completed surgery, chemotherapy, and radiation, and were taking adjuvant hormonal therapy. Standardized instruments were used: Brief Fatigue Inventory, Brief Pain Inventory, Menopause Specific Quality of Life Questionnaire, Pain Catastrophizing Scale, Modified Morisky Medication Adherence Scale, and Beliefs about Medicines Questionnaire. T-tests were used to compare symptoms by type of medication. Pearson correlations examined associations between medication taking behaviors and symptoms.108 women enrolled: mean age 64 (SD 9) years, 81% white. Mean time from surgery was 46 (SD 29) months and on hormonal therapy, overall and current, was 41 (SD 30) and 26 (SD 20) months, respectively. 19% were taking tamoxifen and 81% an AI (30% anastrozole; 18% exemestane; 33% letrozole). 27% changed therapy. Reasons for change were pain (tamoxifen n=8 vs AI n=20), vasomotor symptoms (1 vs 1), osteoporosis (1 vs 3), and rash (1 vs 1). Significantly (p<.05) more fatigue, pain intensity, and pain interference were reported with AI compared to tamoxifen. Significant (p<.05) predictors of nonadherent medication taking behaviors were: greater fatigue (r=.28), pain intensity (r=.28), pain interference (r=.35), pain catastrophizing (r=.30), menopausal symptoms (r=.41), and medication concerns (r=.29). Type of medication and perceived medication necessity were not associated with nonadherent medication taking behaviors.Side effects and perceived side effect severity are associated with nonadherent medication taking behavior. Interventions to address perceived side effects may improve adherence to therapy. [Table: see text].

Authors
Shelby, RA; Keefe, FJ; Red, SN; Blackwell, KL; Peppercorn, JM; Marcom, PK; Kimmick, GG
MLA Citation
Shelby, RA, Keefe, FJ, Red, SN, Blackwell, KL, Peppercorn, JM, Marcom, PK, and Kimmick, GG. "Symptom experiences and nonadherent medication-taking behaviors of breast cancer patients taking adjuvant hormone therapy." Journal of clinical oncology : official journal of the American Society of Clinical Oncology 29.15_suppl (May 2011): 524-.
PMID
28021329
Source
epmc
Published In
Journal of Clinical Oncology
Volume
29
Issue
15_suppl
Publish Date
2011
Start Page
524

Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study.

Non-cardiac chest pain (NCCP) is a common and distressing condition. Prior studies suggest that psychotropic medication or pain coping skills training (CST) may benefit NCCP patients. To our knowledge, no clinical trials have examined the separate and combined effects of CST and psychotropic medication in the management of NCCP. This randomized clinical trial examined the separate and combined effects of CST and antidepressant medication (sertraline) in participants with non-cardiac chest pain. A sample of individuals diagnosed with NCCP was randomly assigned to one of four treatments: (1) CST plus sertraline (CST+sertraline), (2) CST plus placebo (CST+placebo), (3) sertraline alone, or (4) placebo alone. Assessments of pain intensity, pain unpleasantness, anxiety, pain catastrophizing, depression, and physical disability were collected prior to treatment, and at 10- and 34-weeks following randomization. Data analyses revealed that CST and sertraline either alone or in combination significantly reduced pain intensity and pain unpleasantness. The combination of CST plus sertraline may have the greatest promise in that, when compared to placebo alone, it not only significantly reduced pain but also pain catastrophizing and anxiety. Overall, these findings support the importance of further research on the effects of CST and sertraline for non-cardiac chest pain.

Authors
Keefe, FJ; Shelby, RA; Somers, TJ; Varia, I; Blazing, M; Waters, SJ; McKee, D; Silva, S; She, L; Blumenthal, JA; O'Connor, J; Knowles, V; Johnson, P; Bradley, L
MLA Citation
Keefe, FJ, Shelby, RA, Somers, TJ, Varia, I, Blazing, M, Waters, SJ, McKee, D, Silva, S, She, L, Blumenthal, JA, O'Connor, J, Knowles, V, Johnson, P, and Bradley, L. "Effects of coping skills training and sertraline in patients with non-cardiac chest pain: a randomized controlled study." Pain 152.4 (April 2011): 730-741.
PMID
21324590
Source
pubmed
Published In
Pain
Volume
152
Issue
4
Publish Date
2011
Start Page
730
End Page
741
DOI
10.1016/j.pain.2010.08.040

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

PSYCHOLOGICAL FACTORS ASSOCIATED WITH SELF-REPORTED BREAST PAIN PRIOR TO ROUTINE MAMMOGRAPHY IN BREAST CANCER SURVIVORS AND WOMEN WITHOUT A HISTORY OF CANCER

Authors
Shelby, RA; Keefe, FJ; Soo, MS; Skinner, CS; Stinnett, S; Luce, MF; Zuley, ML; Sumkin, JH; Bovbjerg, DH
MLA Citation
Shelby, RA, Keefe, FJ, Soo, MS, Skinner, CS, Stinnett, S, Luce, MF, Zuley, ML, Sumkin, JH, and Bovbjerg, DH. "PSYCHOLOGICAL FACTORS ASSOCIATED WITH SELF-REPORTED BREAST PAIN PRIOR TO ROUTINE MAMMOGRAPHY IN BREAST CANCER SURVIVORS AND WOMEN WITHOUT A HISTORY OF CANCER." ANNALS OF BEHAVIORAL MEDICINE 41 (April 2011): S160-S160.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
41
Publish Date
2011
Start Page
S160
End Page
S160

Sexual concerns in lung cancer patients: an examination of predictors and moderating effects of age and gender.

PURPOSE: Sexual concerns are understudied and undertreated for patients with lung cancer. Objectives were to: (1) assess sexual concerns in lung cancer patients and examine differences by age and gender; (2) examine stability of sexual concerns over time; and (3) evaluate whether sexual concerns in lung cancer patients are significantly related to physical and emotional symptoms. MATERIALS AND METHODS: Data were collected from lung cancer patients during four outpatient clinic visits over 6 months. Measures included sexual concerns (reduced sexual enjoyment, interest, or performance), fatigue (FACIT Fatigue Scale), shortness of breath, and emotional distress (acute distress, despair; Patient Care Monitor). Linear mixed model analyses were conducted. RESULTS: Sexual concerns were common, with 52% of patients reporting at least mild sexual concerns and were stable. Sexual concerns were significantly associated with physical and emotional symptoms; particularly strong relationships were found between sexual concerns and shortness of breath and emotional distress. Age moderated the relationship between both fatigue and shortness of breath and sexual concerns; gender moderated the relationship between emotional distress and sexual concerns. CONCLUSIONS: Self-reported sexual concerns are common in people with lung cancer, are stable, and are related significantly to physical and emotional symptoms; age and gender influence the distress associated with sexual symptoms in this population. Better attention to patient concerns, treatment, and more research are clearly needed.

Authors
Reese, JB; Shelby, RA; Abernethy, AP
MLA Citation
Reese, JB, Shelby, RA, and Abernethy, AP. "Sexual concerns in lung cancer patients: an examination of predictors and moderating effects of age and gender." Support Care Cancer 19.1 (January 2011): 161-165.
PMID
20820818
Source
pubmed
Published In
Supportive Care in Cancer
Volume
19
Issue
1
Publish Date
2011
Start Page
161
End Page
165
DOI
10.1007/s00520-010-1000-0

Chronic pain and adherence

Chronic pain of non-malignant etiology is a significant problem. Chronic non-malignant pain is typically defined as pain that persists for 3 months or longer and that is non-life threatening [1, 2]. Among the most common chronic pain conditions are chronic back pain, migraine headaches, and tension headaches. Chronic pain is very common. In the United States, 17% of patients seen in primary care report chronic pain [3], and chronic pain accounts for almost 80% of all physician visits [4]. A review of 15 epidemiologic studies found that the prevalence of chronic pain ranges from 2 to 40% in the adult population, with a median point prevalence of 15% [5]. The personal and economic costs of chronic pain are substantial. A study of primary care patients found that 13% of headache patients and 18% of back pain patients were unable to maintain full-time work over a 3-year period due to pain [6]. Chronic pain is often accompanied by substantial decreases in physical functioning, disruption of social and family roles, and psychological distress [4]. © 2010 Springer Science+Business Media, LLC.

Authors
Shelby, RA; Keefe, FJ
MLA Citation
Shelby, RA, and Keefe, FJ. "Chronic pain and adherence." (December 1, 2010): 179-214. (Chapter)
Source
scopus
Publish Date
2010
Start Page
179
End Page
214
DOI
10.1007/978-1-4419-5866-2_8

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

Validation of the Patient Care Monitor (Version 2.0): a review of system assessment instrument for cancer patients.

CONTEXT: The Patient Care Monitor (PCM) is a review of systems survey delivered by means of an electronic patient-reported outcomes (ePRO) data capture system that uses wireless tablet computers. Although the PCM 1.0 is validated, the updated PCM 2.0 has not been validated nor tested in the academic setting. OBJECTIVES: To validate and test the PCM 2.0 in three cancer populations. METHODS: Two hundred seventy-five individuals participated in three clinical trials enrolling breast (n=65), gastrointestinal (n=113), and lung (n=97) cancer patients. Internal consistency was evaluated using Cronbach's alpha coefficients calculated for six PCM subscales (general physical symptoms, treatment side effects, distress, despair, impaired performance, and impaired ambulation) and a Quality-of-Life Index. Construct validity was evaluated through Pearson's correlation between PCM subscales and subscales of the Functional Assessment of Cancer Therapy--General (FACT-G), the M.D. Anderson Symptom Inventory (MDASI), and the Functional Assessment of Chronic Illness Therapy--Fatigue (FACIT-F). The participants had the following characteristics: mean age was 58 years (standard deviation: 11), 52% were females, 79% were whites, 17% were blacks, 62% had no college degree, and 78% had metastatic or recurrent disease. RESULTS: Raw and normalized scores for PCM 2.0 subscales were internally consistent across study cohorts. PCM 2.0 subscales correlated significantly (P<0.05) with the corresponding subscales on FACT-G, MDASI, and FACIT-F, with the exception of FACT-G social well-being, particularly for the lung cancer population. These correlations demonstrated construct validity. PCM 2.0 results followed expected patterns by cancer etiology. Prior reports demonstrate patient satisfaction with PCM 2.0. CONCLUSION: Within three unique academic oncology populations, PCM 2.0 is a valid ePRO instrument for assessing symptoms with seven patient-centered subscale or index domains.

Authors
Abernethy, AP; Zafar, SY; Uronis, H; Wheeler, JL; Coan, A; Rowe, K; Shelby, RA; Fowler, R; Herndon, JE
MLA Citation
Abernethy, AP, Zafar, SY, Uronis, H, Wheeler, JL, Coan, A, Rowe, K, Shelby, RA, Fowler, R, and Herndon, JE. "Validation of the Patient Care Monitor (Version 2.0): a review of system assessment instrument for cancer patients." J Pain Symptom Manage 40.4 (October 2010): 545-558.
PMID
20579839
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
40
Issue
4
Publish Date
2010
Start Page
545
End Page
558
DOI
10.1016/j.jpainsymman.2010.01.017

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

PERCEIVED RISK OF BREAST CANCER, BELIEFS ABOUT MAMMOGRAPHY, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER SURVIVORS AND HEALTHY WOMEN AT THE TIME OF MAMMOGRAPHY

Authors
Shelby, RA; Keefe, FJ; Bovbjerg, DH; Skinner, CS; Somers, TJ; Soo, MS; Red, S; Stinnett, S; Luce, MF; Sumkin, J
MLA Citation
Shelby, RA, Keefe, FJ, Bovbjerg, DH, Skinner, CS, Somers, TJ, Soo, MS, Red, S, Stinnett, S, Luce, MF, and Sumkin, J. "PERCEIVED RISK OF BREAST CANCER, BELIEFS ABOUT MAMMOGRAPHY, AND PSYCHOLOGICAL DISTRESS IN BREAST CANCER SURVIVORS AND HEALTHY WOMEN AT THE TIME OF MAMMOGRAPHY." INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE 17 (August 2010): 278-278.
Source
wos-lite
Published In
International Journal of Behavioral Medicine
Volume
17
Publish Date
2010
Start Page
278
End Page
278

SYMPTOM COMMUNICATION IN BREAST CANCER: RELATIONSHIPS OF HOLDING BACK AND SELF EFFICACY FOR COMMUNICATION TO SYMPTOMS AND ADJUSTMENT

Authors
Red, SN; Shelby, RA; Kimmick, GG; Keefe, FJ
MLA Citation
Red, SN, Shelby, RA, Kimmick, GG, and Keefe, FJ. "SYMPTOM COMMUNICATION IN BREAST CANCER: RELATIONSHIPS OF HOLDING BACK AND SELF EFFICACY FOR COMMUNICATION TO SYMPTOMS AND ADJUSTMENT." INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE 17 (August 2010): 27-27.
Source
wos-lite
Published In
International Journal of Behavioral Medicine
Volume
17
Publish Date
2010
Start Page
27
End Page
27

Disease severity and domain-specific arthritis self-efficacy: relationships to pain and functioning in patients with rheumatoid arthritis.

OBJECTIVE: To examine the degree to which disease severity and domains of self-efficacy (pain, function, and other symptoms) explain pain and functioning in rheumatoid arthritis (RA) patients. METHODS: Patients (n = 263) completed the Arthritis Impact Measurement Scales 2 to assess pain and functioning (physical, affective, and social), the Arthritis Self-Efficacy Scale to assess 3 self-efficacy domains (pain, physical function, and other). Disease severity was assessed with C-reactive protein level, physician's rating, and abnormal joint count. Structural equation modeling was used to examine 3 hypotheses: does disease severity have a direct relationship with pain and each area of functioning, does disease severity have a direct relationship with each arthritis self-efficacy domain, and do the self-efficacy domains mediate the relationship between disease severity and RA pain and each area of functioning. RESULTS: Disease severity was related to pain, physical functioning, and each self-efficacy domain (beta = 0.28-0.56, P < 0.001). Each self-efficacy domain was related to its respective domain of functioning (e.g., self-efficacy for pain was related to pain; beta = 0.36-0.54, P < 0.001). Self-efficacy mediated the relationship between disease severity and pain and functioning (beta = 0.12-0.19, P < 0.001). Self-efficacy for pain control and to perform functional tasks accounted for 32-42% of disease severity's total effect on their respective outcomes (e.g., self-efficacy for pain control accounted for 32% of disease severity's total effect on pain). Variance accounted for by the total model was 52% for pain, 53% for physical functioning, and 44% for affective and social functioning. CONCLUSION: Disease severity and self-efficacy both impact RA functioning, and intervening in these areas may lead to better outcomes.

Authors
Somers, TJ; Shelby, RA; Keefe, FJ; Godiwala, N; Lumley, MA; Mosley-Williams, A; Rice, JR; Caldwell, D
MLA Citation
Somers, TJ, Shelby, RA, Keefe, FJ, Godiwala, N, Lumley, MA, Mosley-Williams, A, Rice, JR, and Caldwell, D. "Disease severity and domain-specific arthritis self-efficacy: relationships to pain and functioning in patients with rheumatoid arthritis." Arthritis Care Res (Hoboken) 62.6 (June 2010): 848-856.
PMID
20535796
Source
pubmed
Published In
Arthritis Care and Research
Volume
62
Issue
6
Publish Date
2010
Start Page
848
End Page
856
DOI
10.1002/acr.20127

Catastrophizing and pain coping: moving forward.

Authors
Keefe, FJ; Shelby, RA; Somers, TJ
MLA Citation
Keefe, FJ, Shelby, RA, and Somers, TJ. "Catastrophizing and pain coping: moving forward." Pain 149.2 (May 2010): 165-166.
PMID
20211526
Source
pubmed
Published In
Pain
Volume
149
Issue
2
Publish Date
2010
Start Page
165
End Page
166
DOI
10.1016/j.pain.2010.02.030

Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability.

OBJECTIVE: To examine the contributions of chest pain, anxiety, and pain catastrophizing to disability in 97 patients with noncardiac chest pain (NCCP) and to test whether chest pain and anxiety were related indirectly to greater disability via pain catastrophizing. METHODS: Participants completed daily diaries measuring chest pain for 7 days before completing measures of pain catastrophizing, trait anxiety, and disability. Linear path model analyses examined the contributions of chest pain, trait anxiety, and catastrophizing to physical disability, psychosocial disability, and disability in work, home, and recreational activities. RESULTS: Path models accounted for a significant amount of the variability in disability scales (R(2) = 0.35 to 0.52). Chest pain and anxiety accounted for 46% of the variance in pain catastrophizing. Both chest pain (beta = 0.18, Sobel test Z = 2.58, p < .01) and trait anxiety (beta = 0.14, Sobel test Z = 2.11, p < .05) demonstrated significant indirect relationships with physical disability via pain catastrophizing. Chest pain demonstrated a significant indirect relationship with psychosocial disability via pain catastrophizing (beta = 0.12, Sobel test Z = 1.96, p = .05). After controlling for the effects of chest pain and anxiety, pain catastrophizing was no longer related to disability in work, home, and recreational activities. CONCLUSIONS: Chest pain and anxiety were directly related to greater disability and indirectly related to physical and psychosocial disability via pain catastrophizing. Efforts to improve functioning in patients with NCCP should consider addressing pain catastrophizing.

Authors
Shelby, RA; Somers, TJ; Keefe, FJ; Silva, SG; McKee, DC; She, L; Waters, SJ; Varia, I; Riordan, YB; Knowles, VM; Blazing, M; Blumenthal, JA; Johnson, P
MLA Citation
Shelby, RA, Somers, TJ, Keefe, FJ, Silva, SG, McKee, DC, She, L, Waters, SJ, Varia, I, Riordan, YB, Knowles, VM, Blazing, M, Blumenthal, JA, and Johnson, P. "Pain catastrophizing in patients with noncardiac chest pain: relationships with pain, anxiety, and disability." Psychosom Med 71.8 (October 2009): 861-868.
PMID
19737857
Source
pubmed
Published In
Psychosomatic Medicine
Volume
71
Issue
8
Publish Date
2009
Start Page
861
End Page
868
DOI
10.1097/PSY.0b013e3181b49584

Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability.

This study examined the degree to which pain catastrophizing and pain-related fear explain pain, psychological disability, physical disability, and walking speed in patients with osteoarthritis (OA) of the knee. Participants in this study were 106 individuals diagnosed as having OA of at least one knee, who reported knee pain persisting for six months or longer. Results suggest that pain catastrophizing explained a significant proportion (all Ps < or = 0.05) of variance in measures of pain (partial r(2) [pr(2)] = 0.10), psychological disability (pr(2) = 0.20), physical disability (pr(2) = 0.11), and gait velocity at normal (pr(2) = 0.04), fast (pr(2) = 0.04), and intermediate speeds (pr(2) = 0.04). Pain-related fear explained a significant proportion of the variance in measures of psychological disability (pr(2) = 0.07) and walking at a fast speed (pr(2) = 0.05). Pain cognitions, particularly pain catastrophizing, appear to be important variables in understanding pain, disability, and walking at normal, fast, and intermediate speeds in knee OA patients. Clinicians interested in understanding variations in pain and disability in this population may benefit by expanding the focus of their inquiries beyond traditional medical and demographic variables to include an assessment of pain catastrophizing and pain-related fear.

Authors
Somers, TJ; Keefe, FJ; Pells, JJ; Dixon, KE; Waters, SJ; Riordan, PA; Blumenthal, JA; McKee, DC; LaCaille, L; Tucker, JM; Schmitt, D; Caldwell, DS; Kraus, VB; Sims, EL; Shelby, RA; Rice, JR
MLA Citation
Somers, TJ, Keefe, FJ, Pells, JJ, Dixon, KE, Waters, SJ, Riordan, PA, Blumenthal, JA, McKee, DC, LaCaille, L, Tucker, JM, Schmitt, D, Caldwell, DS, Kraus, VB, Sims, EL, Shelby, RA, and Rice, JR. "Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability." J Pain Symptom Manage 37.5 (May 2009): 863-872.
PMID
19041218
Source
pubmed
Published In
Journal of Pain and Symptom Management
Volume
37
Issue
5
Publish Date
2009
Start Page
863
End Page
872
DOI
10.1016/j.jpainsymman.2008.05.009

Religious coping and pain associated with sickle cell disease: Exploration of a non-linear model

The current study tested a non-linear model of religious coping among Black patients with Sickle Cell Disease (SCD). We predicted that moderate prayer and church attendance would be associated with less severe affective and sensory ratings of pain, lower levels of psychopathology, and less frequent care utilization. The participants were 67 SCD patients, mean age 36.82∈±∈11.47 (range 18-70) of which 45% were men. Using ANOVA procedures, our results indicated a main effect for the frequency of prayer which showed significant differences for anxiety and hostility. Post-hoc t tests revealed that participants who endorsed moderate frequency of prayer reported significantly less anxiety and hostility, relative to participants who reported high or low frequency of prayer. However, participants who endorsed moderate levels of prayer also reported a significantly higher frequency of visits to the emergency department, relative to participants who reported high or low frequency of prayer. However, reports of pain and psychopathology were more linear with participants who reported the highest frequency of church attendance having the highest reports, moderate among those with moderate frequency of church attendance, and lowest among those with infrequent church attendance. These findings challenge and extend the traditional linear conceptualization of religious coping on clinical outcomes among patients with SCD. Directions for future research are discussed. © 2008 Springer Science + Business Media, LLC.

Authors
O'Connell-Edwards, CF; Edwards, CL; Pearce, M; Wachholtz, AB; Wood, M; Muhammad, M; Leach-Beale, B; Shelby, R; McDougald, CS; Harrison, MO; Feliu, M; Edwards, LY; Whitfield, KE; Merritt, M; Wellington, C; Byrd, G; McNeil, JC; Edmonds, H; Robinson, E
MLA Citation
O'Connell-Edwards, CF, Edwards, CL, Pearce, M, Wachholtz, AB, Wood, M, Muhammad, M, Leach-Beale, B, Shelby, R, McDougald, CS, Harrison, MO, Feliu, M, Edwards, LY, Whitfield, KE, Merritt, M, Wellington, C, Byrd, G, McNeil, JC, Edmonds, H, and Robinson, E. "Religious coping and pain associated with sickle cell disease: Exploration of a non-linear model." Journal of African American Studies 13.1 (2009): 1-13.
Source
scival
Published In
Journal of African American Studies
Volume
13
Issue
1
Publish Date
2009
Start Page
1
End Page
13
DOI
10.1007/s12111-008-9063-4

Randomized Trial of a Decision Aid for BRCA1/BRCA2 Mutation Carriers: Impact on Measures of Decision Making and Satisfaction

Objective: Genetic testing is increasingly part of routine clinical care for women with a family history of breast cancer. Given their substantially elevated risk for breast cancer, BRCA1/BRCA2 mutation carriers must make the difficult decision whether or not to opt for risk reducing mastectomy. To help BRCA1/2 carriers make this decision, the authors developed a computer-based interactive decision aid that was tested against usual care in a randomized controlled trial. Design: After the completion of genetic counseling, 214 female (aged 21-75) BRCA1/BRCA2 mutation carriers were randomized to Usual Care (UC; N = 114) or Usual Care plus Decision Aid (DA; N = 100) arms. UC participants received no additional intervention. DA participants were sent the CD-ROM DA to view at home. Main Outcome Measures: The authors measured final management decision, decisional conflict, decisional satisfaction, and receipt of risk reducing mastectomy at 1-, 6-, and 12-months postrandomization. Results: Longitudinal analyses revealed that the DA was effective among carriers who were initially undecided about how to manage their breast cancer risk. Within this group, the DA led to an increased likelihood of reaching a management decision (OR = 3.09, 95% CI = 1.62, 5.90; p < .001), decreased decisional conflict (B = -.46, z = -3.1, p <.002), and increased satisfaction (B = .27, z = 3.1, p = .002) compared to UC. Among carriers who had already made a management decision by the time of randomization, the DA had no benefit relative to UC. Conclusion: These results demonstrate that BRCA1/BRCA2 mutation carriers who are having difficulty making a breast cancer risk management decision can benefit from adjunct decision support. © 2009 American Psychological Association.

Authors
Schwartz, MD; Valdimarsdottir, HB; DeMarco, TA; Peshkin, BN; Lawrence, W; Rispoli, J; Brown, K; Isaacs, C; O'Neill, S; Shelby, R; Grumet, SC; McGovern, MM; Garnett, S; Bremer, H; Leaman, S; O'Mara, K; Kelleher, S; Komaridis, K
MLA Citation
Schwartz, MD, Valdimarsdottir, HB, DeMarco, TA, Peshkin, BN, Lawrence, W, Rispoli, J, Brown, K, Isaacs, C, O'Neill, S, Shelby, R, Grumet, SC, McGovern, MM, Garnett, S, Bremer, H, Leaman, S, O'Mara, K, Kelleher, S, and Komaridis, K. "Randomized Trial of a Decision Aid for BRCA1/BRCA2 Mutation Carriers: Impact on Measures of Decision Making and Satisfaction." Health Psychology 28.1 (2009): 11-19.
PMID
19210013
Source
scival
Published In
Health Psychology
Volume
28
Issue
1
Publish Date
2009
Start Page
11
End Page
19
DOI
10.1037/a0013147

Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients.

UNLABELLED: This study examined whether self-efficacy mediated the relationship between pain catastrophizing and pain and disability. Participants were 192 individuals diagnosed with osteoarthritis (OA) of the knees who were overweight or obese. Multiple mediator analyses were conducted to simultaneously test self-efficacy for pain control, physical function, and emotional symptoms as mediators while controlling for demographic and medical status variables. Higher pain catastrophizing was associated with lower self-efficacy in all 3 domains (Ps < .05). Self-efficacy for pain control fully mediated the relationship between pain catastrophizing and pain (beta = .08, Sobel test Z = 1.97, P < .05). The relationship between pain catastrophizing and physical disability was fully mediated by self-efficacy for physical function (beta = .06, Sobel test Z = 1.95, P = .05). Self-efficacy for emotional symptoms partially mediated the relationship between pain catastrophizing and psychological disability (beta = .12, Sobel test Z = 2.92, P < .05). These results indicate that higher pain catastrophizing contributed to greater pain and disability via lower domain-specific self-efficacy. Efforts to reduce pain and improve functioning in OA patients should consider addressing pain catastrophizing and domain specific self-efficacy. Pain catastrophizing may be addressed through cognitive therapy techniques and self-efficacy may be enhanced through practice of relevant skills and personal accomplishments. PERSPECTIVE: This study found that higher pain catastrophizing contributed to greater pain and disability via domain specific self-efficacy. These results suggest that treatment efforts to reduce pain and improve functioning in OA patients who are overweight or obese should consider addressing both pain catastrophizing and self-efficacy.

Authors
Shelby, RA; Somers, TJ; Keefe, FJ; Pells, JJ; Dixon, KE; Blumenthal, JA
MLA Citation
Shelby, RA, Somers, TJ, Keefe, FJ, Pells, JJ, Dixon, KE, and Blumenthal, JA. "Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients." J Pain 9.10 (October 2008): 912-919.
PMID
18602871
Source
pubmed
Published In
Journal of Pain
Volume
9
Issue
10
Publish Date
2008
Start Page
912
End Page
919
DOI
10.1016/j.jpain.2008.05.008

Optimism, social support, and adjustment in African American women with breast cancer.

Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism.

Authors
Shelby, RA; Crespin, TR; Wells-Di Gregorio, SM; Lamdan, RM; Siegel, JE; Taylor, KL
MLA Citation
Shelby, RA, Crespin, TR, Wells-Di Gregorio, SM, Lamdan, RM, Siegel, JE, and Taylor, KL. "Optimism, social support, and adjustment in African American women with breast cancer." J Behav Med 31.5 (October 2008): 433-444.
PMID
18712591
Source
pubmed
Published In
Journal of Behavioral Medicine
Volume
31
Issue
5
Publish Date
2008
Start Page
433
End Page
444
DOI
10.1007/s10865-008-9167-2

Arthritis self-efficacy and self-efficacy for resisting eating: relationships to pain, disability, and eating behavior in overweight and obese individuals with osteoarthritic knee pain.

This study examined arthritis self-efficacy and self-efficacy for resisting eating as predictors of pain, disability, and eating behaviors in overweight or obese patients with osteoarthritis (OA) of the knee. Patients (N=174) with a body mass index between 25 and 42 completed measures of arthritis-related self-efficacy, weight-related self-efficacy, pain, physical disability, psychological disability, overeating, and demographic and medical information. Hierarchical linear regression analyses were conducted to examine whether arthritis self-efficacy (efficacy for pain control, physical function, and other symptoms) and self-efficacy for resisting eating accounted for significant variance in pain, disability, and eating behaviors after controlling for demographic and medical characteristics. Analyses also tested whether the contributions of self-efficacy were domain specific. Results showed that self-efficacy for pain accounted for 14% (p=.01) of the variance in pain, compared to only 3% accounted for by self-efficacy for physical function and other symptoms. Self-efficacy for physical function accounted for 10% (p=.001) of the variance in physical disability, while self-efficacy for pain and other symptoms accounted for 3%. Self-efficacy for other (emotional) symptoms and resisting eating accounted for 21% (p<.05) of the variance in psychological disability, while self-efficacy for pain control and physical function were not significant predictors. Self-efficacy for resisting eating accounted for 28% (p=.001) of the variance in eating behaviors. Findings indicate that self-efficacy is important in understanding pain and behavioral adjustment in overweight or obese OA patients. Moreover, the contributions of self-efficacy were domain specific. Interventions targeting both arthritis self-efficacy and self-efficacy for resisting eating may be helpful in this population.

Authors
Pells, JJ; Shelby, RA; Keefe, FJ; Dixon, KE; Blumenthal, JA; Lacaille, L; Tucker, JM; Schmitt, D; Caldwell, DS; Kraus, VB
MLA Citation
Pells, JJ, Shelby, RA, Keefe, FJ, Dixon, KE, Blumenthal, JA, Lacaille, L, Tucker, JM, Schmitt, D, Caldwell, DS, and Kraus, VB. "Arthritis self-efficacy and self-efficacy for resisting eating: relationships to pain, disability, and eating behavior in overweight and obese individuals with osteoarthritic knee pain." Pain 136.3 (June 2008): 340-347.
PMID
17764844
Source
pubmed
Published In
Pain
Volume
136
Issue
3
Publish Date
2008
Start Page
340
End Page
347
DOI
10.1016/j.pain.2007.07.012

PTSD diagnoses, subsyndromal symptoms, and comorbidities contribute to impairments for breast cancer survivors.

The clinical importance of posttraumatic stress disorder (PTSD) symptomatology for cancer patients is unclear. The association between the magnitude of cancer-related PTSD symptoms, comorbidity, and functioning is tested. Breast cancer patients (N = 74) were assessed at diagnosis/surgery, followed, and screened for cancer-related PTSD 18 months later. Participants then completed diagnostic interviews and PTSD (n = 12), subsyndromal PTSD (n = 5), and no symptom (n = 47) patient groups were identified. Posttraumatic stress disorder cases were distinguished by having experienced violent traumas and anxiety disorders predating cancer, whereas subsyndromal cases were not. Also, longitudinal data show that PTSD covarys with poorer functioning and lower quality of life among breast cancer survivors. Both PTSD and subsyndromal PTSD were associated with employment absenteeism and the seeking of mental health services.

Authors
Shelby, RA; Golden-Kreutz, DM; Andersen, BL
MLA Citation
Shelby, RA, Golden-Kreutz, DM, and Andersen, BL. "PTSD diagnoses, subsyndromal symptoms, and comorbidities contribute to impairments for breast cancer survivors." J Trauma Stress 21.2 (April 2008): 165-172.
PMID
18404636
Source
pubmed
Published In
Journal of Traumatic Stress
Volume
21
Issue
2
Publish Date
2008
Start Page
165
End Page
172
DOI
10.1002/jts.20316

Psychoeducational group intervention improves the impact of coping efforts on quality of life in African American women with breast cancer

Authors
Shelby, RA; Lamdan, RM; Siegel, JE; Taylor, KL
MLA Citation
Shelby, RA, Lamdan, RM, Siegel, JE, and Taylor, KL. "Psychoeducational group intervention improves the impact of coping efforts on quality of life in African American women with breast cancer." ANNALS OF BEHAVIORAL MEDICINE 35 (March 2008): S149-S149.
Source
wos-lite
Published In
Annals of Behavioral Medicine
Volume
35
Publish Date
2008
Start Page
S149
End Page
S149

Changes in diet and physical activity following BRCA1/2 testing

The present study prospectively examined change in diet and physical activity behaviors in 115 women undergoing BRCA1/2 gene testing (46 mutation positive, 46 uninformative and 23 definitive negative). Participants completed measures of diet and physical activity at three time points: prior to genetic testing and 1-and 6-months after receipt of genetic test results. Repeated measures analyses examined between-and within-group differences among participants who received BRCA1/2 positive, uninformative, or definitive negative results. There were no within-group differences across time points or between-group differences at any time point for diet or physical activity. Most participants, overall and within each group, did not meet recommended guidelines for fruit and vegetable and dietary fat consumption. These findings suggest that women do not make spontaneous changes in diet and physical activity following the genetic testing and counseling process. A brief intervention may be necessary for patients who are interested in making changes in modifiable risk factors to complement more definitive risk-reduction strategies. © 2008 by The Haworth Press.

Authors
O'Neill, SC; Kaufman, E; Demarco, T; Peshkin, BN; McKenna, K; Shelby, R; Valdimarsdottir, H; Rispoli, J; Schwartz, MD
MLA Citation
O'Neill, SC, Kaufman, E, Demarco, T, Peshkin, BN, McKenna, K, Shelby, R, Valdimarsdottir, H, Rispoli, J, and Schwartz, MD. "Changes in diet and physical activity following BRCA1/2 testing." Journal of Psychosocial Oncology 26.3 (2008): 63-80.
PMID
19042265
Source
scival
Published In
Journal of Psychosocial Oncology
Volume
26
Issue
3
Publish Date
2008
Start Page
63
End Page
80
DOI
10.1080/07347330802116051

RCT of a Psychological Intervention for Patients With Cancer: I. Mechanisms of Change

Little is known about the therapeutic processes contributing to efficacy of psychological interventions for patients with cancer. Data from a randomized clinical trial yielding robust biobehavioral and health effects (B. L. Andersen et al., 2004, 2007) were used to examine associations between process variables, treatment utilization, and outcomes. Novel findings emerged. Patients were highly satisfied with the treatment, but their higher levels of felt support (group cohesion) covaried with lower distress and fewer symptoms. Also, specific treatment strategies were associated with specific outcomes, including lower distress, improved dietary habits, reduced symptomatology, and higher chemotherapy dose intensity. These data provide a comprehensive test of multiple therapeutic processes and mechanisms for biobehavioral change with an intervention including both intensive and maintenance phases. © 2007 American Psychological Association.

Authors
Andersen, BL; Shelby, RA; Golden-Kreutz, DM
MLA Citation
Andersen, BL, Shelby, RA, and Golden-Kreutz, DM. "RCT of a Psychological Intervention for Patients With Cancer: I. Mechanisms of Change." Journal of Consulting and Clinical Psychology 75.6 (2007): 927-938.
PMID
18085909
Source
scival
Published In
Journal of Consulting and Clinical Psychology
Volume
75
Issue
6
Publish Date
2007
Start Page
927
End Page
938
DOI
10.1037/0022-006X.75.6.927

Parental substance abuse, reports of chronic pain and coping in adult patients with sickle cell disease.

There is increasing interest from a social learning perspective in understanding the role of parental factors on adult health behaviors and health outcomes. Our review revealed no studies, to date, that have evaluated the effects of parental substance abuse on reports of chronic pain and coping in adult patients with sickle cell disease (SCD). We explored the effects of parental substance (alcohol or drug) abuse on reports of the sensory, affective and summary indices of pain in 67 adult patients, mean age 38.9 (13.5), with SCD. We also explored the effects of parental substance abuse on psychopathology associated with pain and active coping. Twenty-four percent of patients reported that their parent(s) abused substances. Patients whose parent(s) were characterized as substance abusers reported greater sensory (p=0.02), affective (p=0.01) and summary (VAS; p=0.02) indices of pain as compared to their counterparts, whose parent(s) were not characterized as substance abusers. Patients did not differ in average age, education or the propensity to respond in a socially acceptable manner. There was a significant trend towards patients who characterized their parents as abusers scoring higher than their counterparts on active coping. We propose a Social Learning Theory to explain the current findings and suggest a need for additional prospective research to simultaneously explore biological (genetic) and social factors that influence the interpretation, experience and reporting of chronic pain in adult patients with chronic disease.

Authors
Edwards, C; Whitfield, K; Sudhakar, S; Pearce, M; Byrd, G; Wood, M; Feliu, M; Leach-Beale, B; DeCastro, L; Whitworth, E; Abrams, M; Jonassaint, J; Harrison, MO; Mathis, M; Scott, L; Johnson, S; Durant, L; Holmes, A; Presnell, K; Bennett, G; Shelby, R; Robinson, E
MLA Citation
Edwards, C, Whitfield, K, Sudhakar, S, Pearce, M, Byrd, G, Wood, M, Feliu, M, Leach-Beale, B, DeCastro, L, Whitworth, E, Abrams, M, Jonassaint, J, Harrison, MO, Mathis, M, Scott, L, Johnson, S, Durant, L, Holmes, A, Presnell, K, Bennett, G, Shelby, R, and Robinson, E. "Parental substance abuse, reports of chronic pain and coping in adult patients with sickle cell disease." J Natl Med Assoc 98.3 (March 2006): 420-428.
PMID
16573309
Source
pubmed
Published In
Journal of the National Medical Association
Volume
98
Issue
3
Publish Date
2006
Start Page
420
End Page
428

Standardized versus open-ended assessment of psychosocial and medical concerns among African American breast cancer patients

Standardized quality of life measures have been developed and used primarily with Caucasian and middle-class cancer patients. This study assessed the ability of several widely used standardized measures to capture the concerns and problems of 89 African American breast cancer patients. Concerns and problems were assessed using both an open-ended format and standardized measures. The degree of overlap in responses from these two formats was examined. The most frequently reported problems in the open-ended format included physical (43%), financial (40%), and worry about others (30%). Overall, standardized measures had significant overlap with open-ended concerns and problems. The Cancer Rehabilitation Evaluation System-Short Form subscales/items were associated with corresponding open-ended physical, financial, and social problems (R2 change=0.07-0.16, p's≤0.02), the Interpersonal Support Evaluation List-Short Form was associated with open-ended social problems (R2 change = 0.11 p=0.004), and the Mental Health Inventory was associated with open-ended psychological distress problems (R2 change=0.08, p=0.01). One category of open-ended problems, worry about others, was not captured by standardized measures. With the exception of associations between open-ended physical problems and psychological distress measures, there were few significant correlations between standardized measures and dissimilar problem categories. These findings suggest that the standardized measures in this study reflected the concerns and problems of African American breast cancer patients. Additional studies are needed to evaluate the utility of other widely used standardized measures that have not been developed or standardized among non-white samples. Copyright © 2005 John Wiley & Sons, Ltd.

Authors
Shelby, RA; Lamdan, RM; Siegel, JE; Hrywna, M; Taylor, KL
MLA Citation
Shelby, RA, Lamdan, RM, Siegel, JE, Hrywna, M, and Taylor, KL. "Standardized versus open-ended assessment of psychosocial and medical concerns among African American breast cancer patients." Psycho-Oncology 15.5 (2006): 382-397.
PMID
16155965
Source
scival
Published In
Psycho-Oncology
Volume
15
Issue
5
Publish Date
2006
Start Page
382
End Page
397
DOI
10.1002/pon.959

Traumatic stress, perceived global stress, and life events: Prospectively predicting quality of life in breast cancer patients

The authors investigated the relationship between stress at initial cancer diagnosis and treatment and subsequent quality of life (QoL). Women (n = 112) randomized to the assessment-only arm of a clinical trial were initially assessed after breast cancer diagnosis and surgery and then reassessed at 4 months (during adjuvant treatment) and 12 months (postadjuvant treatment). There were 3 types of stress measured: number of stressful life events (K. A. Matthews et al., 1997), cancer-related traumatic stress symptoms (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979), and perceived global stress (S. Cohen, T. Kamarck, & R. Mermelstein, 1983). Using hierarchical multiple regressions, the authors found that stress predicted both psychological and physical QoL (J. E. Ware, K. K. Snow, & M. Kosinski, 2000) at the follow-ups (all ps < .03). These findings substantiate the relationship between initial stress and later QoL and underscore the need for timely psychological intervention. Copyright 2005 by the American Psychological Association.

Authors
Golden-Kreutz, DM; Thornton, LM; Gregorio, SW-D; Frierson, GM; Jim, HS; Carpenter, KM; Shelby, RA; Andersen, BL
MLA Citation
Golden-Kreutz, DM, Thornton, LM, Gregorio, SW-D, Frierson, GM, Jim, HS, Carpenter, KM, Shelby, RA, and Andersen, BL. "Traumatic stress, perceived global stress, and life events: Prospectively predicting quality of life in breast cancer patients." Health Psychology 24.3 (2005): 288-296.
PMID
15898865
Source
scival
Published In
Health Psychology
Volume
24
Issue
3
Publish Date
2005
Start Page
288
End Page
296
DOI
10.1037/0278-6133.24.3.288

Mismatch of posttraumatic stress disorder (PTSD) symptoms and DSM-IV symptom clusters in a cancer sample: Exploratory factor analysis of the PTSD checklist-civilian version

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms. © 2005 International Society for Traumatic Stress Studies.

Authors
Shelby, RA; Golden-Kreutz, DM; Andersen, BL
MLA Citation
Shelby, RA, Golden-Kreutz, DM, and Andersen, BL. "Mismatch of posttraumatic stress disorder (PTSD) symptoms and DSM-IV symptom clusters in a cancer sample: Exploratory factor analysis of the PTSD checklist-civilian version." Journal of Traumatic Stress 18.4 (2005): 347-357.
PMID
16281232
Source
scival
Published In
Journal of Traumatic Stress
Volume
18
Issue
4
Publish Date
2005
Start Page
347
End Page
357
DOI
10.1002/jts.20033

TNF-α levels in cancer patients relate to social variables

Tumor necrosis factor-α (TNF-α) is an important cytokine associated with tumor regression and increased survival time for cancer patients. Research evidence relates immune factors (e.g., natural killer (NK) cell counts, NK cell lysis, lymphocyte profile, and lymphocyte proliferation) to the frequency and quality of social relations among cancer patients. We hypothesized that disruptions in social relations would be associated with lower TNF-α responses, and conversely, that reports of positive changes in social relations correlate with stronger responses. A prospective design measured changes in social activity and relationship satisfaction with a partner in 44 breast cancer patients at the time of cancer diagnosis, and initial surgery and 12 months later. Results indicated that patients reporting increased social activities or satisfaction exhibited stronger stimulated TNF-α responses. This is the first study to link changes in patient social relations with a cancer-relevant immune variable. © 2005 Elsevier Inc. All rights reserved.

Authors
Marucha, PT; Crespin, TR; Shelby, RA; Andersen, BL
MLA Citation
Marucha, PT, Crespin, TR, Shelby, RA, and Andersen, BL. "TNF-α levels in cancer patients relate to social variables." Brain, Behavior, and Immunity 19.6 (2005): 521-525.
PMID
15890493
Source
scival
Published In
Brain, Behavior, and Immunity
Volume
19
Issue
6
Publish Date
2005
Start Page
521
End Page
525
DOI
10.1016/j.bbi.2005.03.014

Quality of life and trial adherence among participants in the prostate, lung, colorectal, and ovarian cancer screening trial

Background: The National Cancer Institute's Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial was designed to examine whether annual screening tests for these four tumor sites result in reduced disease-related mortality. We assessed the impact of trial participation on both health-related quality of life (HRQL) and trial adherence. Methods: Participants (N = 432; 217 in the control arm and 215 in screening arm) were accrued from the Georgetown University PLCO site from May through December 1998. Screening-arm participants were interviewed by telephone at baseline (prescreening), shortly after notification of screening results (short-term follow-up), and 9 months after notification of screening results (intermediate-term follow up). Control-arm participants completed a baseline and 1-year follow-up assessment. Logistic regression analyses were conducted. Results: Participants reported high levels of HRQL and satisfaction with their decision to participate. Screening-arm participants with abnormal screening results had a higher level of intrusive thoughts about cancer than those with all normal results (odds ratio [OR] = 2.9, 95% confidence interval [CI] = 1.3 to 6.3) at the short-term follow-up but not at the intermediate-term follow-up (when abnormal test results were known to be false positive; OR = 1.9, 95% CI = 0.89 to 4.2). Trial adherence was statistically significantly better among participants who had received all normal results in the previous year's screening tests (93.7% versus 78.7%; OR = 3.7, CI = 1.1 to 12.0) than in those who received at least one abnormal result. In the control arm, adherence (defined as returning annual questionnaires) was positively associated with education (OR = 3.4, 95% CI = 1.4 to 8.4) and sex, with women being more likely to return questionnaires than men (OR = 2.1, 95% CI = 1.05 to 4.4). Conclusions: It is feasible to collect HRQL measures as part of a large cancer screening trial. Prior abnormal screening results were related to short-term HRQL but not to intermediate-term HRQL. Trial adherence was poorer among those who had received previous false-positive results. These results suggest several methods for improving adherence in this and other subgroups. © Oxford University Press 2004, all rights reserved.

Authors
Taylor, KL; Shelby, R; Gelmann, E; McGuire, C
MLA Citation
Taylor, KL, Shelby, R, Gelmann, E, and McGuire, C. "Quality of life and trial adherence among participants in the prostate, lung, colorectal, and ovarian cancer screening trial." Journal of the National Cancer Institute 96.14 (2004): 1083-1094.
PMID
15265970
Source
scival
Published In
Journal of the National Cancer Institute
Volume
96
Issue
14
Publish Date
2004
Start Page
1083
End Page
1094

Psychological adjustment among African American breast cancer patients: One-year follow-up results of a randomized psychoeducational group intervention

The effectiveness of support group interventions for cancer patients has been established among White patients but has been virtually unstudied among minority patients. The current study represents the 1st randomized support group intervention targeted to African American women with breast cancer. Participants (N = 73) with nonmetastatic breast cancer were randomly assigned to an 8-week group intervention or an assessment-only control condition At 12 months, the intervention resulted in improved mood as well as improved general and cancer-specific psychological functioning among women with greater baseline distress or lower income. Subsequent research is needed to address effective methods of enrolling and following women with fewer psychosocial and financial resources, as they were the most likely to benefit from this particular intervention.

Authors
Taylor, KL; Lamdan, RM; Siegel, JE; Shelby, R; Moran-Klimi, K; Hrywna, M
MLA Citation
Taylor, KL, Lamdan, RM, Siegel, JE, Shelby, R, Moran-Klimi, K, and Hrywna, M. "Psychological adjustment among African American breast cancer patients: One-year follow-up results of a randomized psychoeducational group intervention." Health Psychology 22.3 (2003): 316-323.
PMID
12790260
Source
scival
Published In
Health Psychology
Volume
22
Issue
3
Publish Date
2003
Start Page
316
End Page
323
DOI
10.1037/0278-6133.22.3.316

Development of an interactive decision aid for female BRCA1/BRCA2 carriers

Shared decision making between patients and providers is becoming increasingly common, particularly when there is no clear preferred course of action. As a result, decision aids are being adopted with growing frequency and have been applied to many medical decision-making issues. One such issue where there is uncertainty is breast cancer risk management among BRCA1/BRCA2 carriers. We present the development of a CD-ROM decision aid to facilitate risk management decision making in this population. Our decision aid was developed with the intention of providing it through a randomized clinical trial. The CD-ROM is a multimedia, interactive intervention which provides information about breast cancer, risks associated with BRCA1 and BRCA2 mutations, risk management options for hereditary breast cancer, and a breast cancer risk management decision aid. The goal of this CD-ROM, offered as an adjunctive intervention, is to reduce decisional conflict and psychological distress and improve comprehension of risk information, decisional satisfaction, medical adherence, and quality of life for this population of women at increased risk for breast cancer.

Authors
Kaufman, EM; Peshkin, BN; Lawrence, WF; Shelby, R; Isaacs, C; Brown, K; Rispoli, J; O'Neill, S; Hurley, K; DeMarco, T; Brogan, B; Grumet, S; Jandorf, L; McKenna, K; Valdimarsdottir, H; Schwartz, MD
MLA Citation
Kaufman, EM, Peshkin, BN, Lawrence, WF, Shelby, R, Isaacs, C, Brown, K, Rispoli, J, O'Neill, S, Hurley, K, DeMarco, T, Brogan, B, Grumet, S, Jandorf, L, McKenna, K, Valdimarsdottir, H, and Schwartz, MD. "Development of an interactive decision aid for female BRCA1/BRCA2 carriers." Journal of Genetic Counseling 12.2 (2003): 109-129.
Source
scival
Published In
Journal of Genetic Counseling
Volume
12
Issue
2
Publish Date
2003
Start Page
109
End Page
129

Treatment regimen, sexual attractiveness concerns and psychological adjustment among African American breast cancer patients

Background: Among a sample of African American women recently diagnosed with breast cancer, we assessed the consequences of different treatment regimens on sexual attractiveness concerns, and the impact of sexual attractiveness concerns on current and subsequent psychological adjustment. Patients and methods: The sample included 91 African American women with breast cancer: 90% had Stage I or II disease, 48% had chemotherapy, 47% had a lumpectomy, and 53% received a mastectomy. Feelings of sexual attractiveness and psychological adjustment were assessed an average of 3 months following surgery and again 4 months post-baseline. Results: Regression analyses revealed that chemotherapy was associated with greater concerns about sexual attractiveness among lumpectomy patients (p < 0.05), but not among mastectomy patients (p > 0.20). The interaction also suggested that chemotherapy equalized the impact of types of surgery, as there was no difference on sexual attractiveness between surgery groups among women who had received chemotherapy (p > 0.20). However, among women who had not received chemotherapy, mastectomy patients reported greater sexual attractiveness concerns (p < 0.01). Finally, regression analyses revealed that feelings of sexual attractiveness were an important component of psychological well-being, both cross-sectionally (p < 0.001) and longitudinally (p < 0.001). Conclusion: Assessment of the combined impact of different treatment regimens on feelings of sexual attractiveness is particularly important given the current consensus that all breast cancer patients should receive chemotherapy, regardless of nodal status. Further, concerns about sexual attractiveness should be considered for inclusion as one component of psychosocial support programs for African American women with breast cancer, as our results suggested that they played a significant role in psychological adjustment. Copyright © 2002 John Wiley & Sons, Ltd.

Authors
Taylor, KL; Lamdan, RM; Siegel, JE; Shelby, R; Hrywna, M; Moran-Klimi, K
MLA Citation
Taylor, KL, Lamdan, RM, Siegel, JE, Shelby, R, Hrywna, M, and Moran-Klimi, K. "Treatment regimen, sexual attractiveness concerns and psychological adjustment among African American breast cancer patients." Psycho-Oncology 11.6 (2002): 505-517.
PMID
12476432
Source
scival
Published In
Psycho-Oncology
Volume
11
Issue
6
Publish Date
2002
Start Page
505
End Page
517
DOI
10.1002/pon.616

The role of community-based and philanthropic organizations in meeting cancer patient and caregiver needs

We examined information from community-based and philanthropic organizations to document the cancer-related services that are currently available, establish which services are still needed, and determine who utilizes these formal support networks. In Phase I, 32 of 41 eligible organizations participated in a survey conducted from December 1999 to March 2000. The most common mission focus among participating organizations was information/referral-centered. The most common services provided were referrals to information resources and provision of cancer-related information. Only two of the organizations in Phase I provided client demographic information and both indicated that client populations were predominantly white, female, and over age 40. Phase II of the study involved analyzing patient data from Cancer Care, Inc., a national service organization for cancer patients. Between 1983 and 1997, there were 2,714 prostate cancer patients and 9,451 breast cancer patients included in the Cancer Care database. Their most commonly reported problems were related to personal adjustment to illness, financial, home care, and transportation needs. There were significant differences in problems reported depending upon age and disease status. In addition, the results of this study support the idea that those at highest risk for developing and dying of cancer are the least likely to utilize formal support networks. Further, a gap in service provision for assistance with practical needs (e.g., transportation, home care, child care, psychosocial support) was identified. Due to the increasing use of outpatient care for cancer patients, a greater demand for practical assistance can be expected in the future. The availability of practical services will need to be increased in order to effectively meet cancer patient needs.

Authors
Shelby, RA; Taylor, KL; Kerner, JF; Coleman, E; Blum, D
MLA Citation
Shelby, RA, Taylor, KL, Kerner, JF, Coleman, E, and Blum, D. "The role of community-based and philanthropic organizations in meeting cancer patient and caregiver needs." Ca-A Cancer Journal for Clinicians 52.4 (2002): 229-246.
PMID
12139234
Source
scival
Published In
Ca: A Cancer Journal for Clinicians
Volume
52
Issue
4
Publish Date
2002
Start Page
229
End Page
246

The impact of item order on ratings of cancer risk perception

Although perceived risk is central to most theories of health behavior, there is little consensus on its measurement with regard to item wording, response set, or the number of items to include. In a methodological assessment of perceived risk, we assessed the impact of changing the order of three commonly used perceived risk items: quantitative personal risk, quantitative population risk, and comparative risk. Participants were 432 men and women enrolled in an ancillary study of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Three groups of consecutively enrolled participants responded to the three items in one of three question orders. Results indicated that item order was related to the perceived risk ratings of both ovarian (P < 0.05) and colorectal (P < 0.05) cancers. Perceptions of risk were significantly lower when the comparative rating was made first. The findings suggest that compelling participants to consider their own risk relative to the risk of others results in lower ratings of perceived risk. Although the use of multiple items may provide more information than when only a single method is used, different conclusions may be reached depending on the context in which an item is assessed.

Authors
Taylor, KL; Shelby, RA; Schwartz, MD; Ackerman, J; LaSalle, VH; Gelmann, EP; McGuire, C
MLA Citation
Taylor, KL, Shelby, RA, Schwartz, MD, Ackerman, J, LaSalle, VH, Gelmann, EP, and McGuire, C. "The impact of item order on ratings of cancer risk perception." Cancer Epidemiology Biomarkers and Prevention 11.7 (2002): 654-659.
PMID
12101113
Source
scival
Published In
Cancer Epidemiology Biomarkers and Prevention
Volume
11
Issue
7
Publish Date
2002
Start Page
654
End Page
659

Impact of undergoing prostate carcinoma screening on prostate carcinoma-related knowledge and distress

BACKGROUND. Despite the ongoing controversy regarding the utility of prostate carcinoma (PCa) screening, the prevalence of asymptomatic men who participate in free PCa screening programs is on the rise. However, this increased awareness has not been associated with increased knowledge about the potential limitations of PCa creening. We conducted a prospective assessment to delineate men's motivations for undergoing screening and to determine the impact of screening on psychological distress and on men's knowledge about PCa screening. METHODS. We conducted two telephone interviews with a group of 136 men registered to undergo free PCa screening at two hospital-based sites. The first interview was conducted before screening and the second interview followed receipt of the screening results. Interviews assessed demographics and screening history, reasons for undergoing the current screening, cancer-related and general psychological distress, knowledge of risk factors for PCa, and knowledge of the benefits and limitations of screening. Only participants with normal screening results were included in these analyses. RESULTS. "Seeking peace of mind about prostate cancer" was rated as the most important reason for undergoing screening. PCa-related distress decreased following receipt of a negative result (P < 0.01). Stratified analyses indicated that this was particularly true among younger men and African American men (both Ps < 0.001). Awareness of the benefits of screening was very high, but awareness of limitations was low, with fewer limitations reported following screening compared with pre-screening (P < 0.01). Although awareness of the established risk factors improved following screening, controversial risk factors (i.e., those with limited empirical support) and factors that were unrelated to PCa risk were also rated as more important in the development of PCa than they were before screening (all Ps < 0.05). Therefore, the results may reflect that following screening, participants were simply more likely to endorse plausible risk factors, rather than actually reflecting an increase in participants' knowledge. CONCLUSIONS. These results suggest the importance of developing informed consent procedures and educational programs for the asymptomatic men who participate in free prostate screening programs each year, as the decision to be screened is being made without the benefit of a full understanding of the current state of medical knowledge about PCa screening. Until the definitive results of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial are available, improved patient education is needed to assist men in making screening decisions consistent with their own preferences. © 2002 American Cancer Society.

Authors
Taylor, KL; Shelby, R; Kerner, J; Redd, W; Lynch, J
MLA Citation
Taylor, KL, Shelby, R, Kerner, J, Redd, W, and Lynch, J. "Impact of undergoing prostate carcinoma screening on prostate carcinoma-related knowledge and distress." Cancer 95.5 (2002): 1037-1044.
PMID
12209688
Source
scival
Published In
Cancer
Volume
95
Issue
5
Publish Date
2002
Start Page
1037
End Page
1044
DOI
10.1002/cncr.10781

Factors contributing to levels of burnout among sex offender treatment providers

This study used the Maslach Burnout Inventory (MBI) to examine burnout among 86 licensed mental health providers who treat sex offenders. Participants were 53.5% male, 43% worked in inpatient/prison settings, and 55.8% worked in group therapy settings. Compared to MBI subscale norms for mental health workers, sex offender treatment providers reported higher levels of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Relative to norms for social services workers, sex offender treatment providers reported higher levels of PA but similar levels of EE and DP. There were no significant differences in burnout levels by gender, number of years working with sex offenders, and percentage of clientele who were sex offenders. Relative to providers in outpatient facilities, those in inpatient/prison facilities reported higher levels of DP, PA, and EE. These findings suggest inpatient/prison providers experience greater levels of burnout relative to outpatient providers.

Authors
Shelby, RA; Stoddart, RM; Taylor, KL
MLA Citation
Shelby, RA, Stoddart, RM, and Taylor, KL. "Factors contributing to levels of burnout among sex offender treatment providers." Journal of Interpersonal Violence 16.11 (2001): 1205-1216.
Source
scival
Published In
Journal of Interpersonal Violence
Volume
16
Issue
11
Publish Date
2001
Start Page
1205
End Page
1216
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