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Background This study examined current physical activity levels and preferences for exercise settings and activities among adult survivors of childhood cancers as a strategy to inform the feasibility and design of such programs. Methods A mixed-methods design was used to investigate current activity levels as well as barriers to and preferences for physical activity among 20 adult survivors of pediatric cancer. Results One-half of participants reported engaging in regular physical activity, although the frequency, intensity, and duration varied. Overall, 17 of the 20 participants (85%) stated they would be interested in participating in a structured exercise intervention, and they expressed a strong interest in walking (76%), bicycling (53%), and weight training (53%). Common barriers to participation in a potential structured exercise program were insufficient time, current health issues, and program location/distance. Nearly all participants agreed that information on nutrition and diet should be included as part of an exercise intervention. Conclusions These findings will help inform the design and implementation of future exercise programs to enhance physical activity among this high-risk group of cancer survivors.

PurposeThis study describes the development of a screening measure focused on the potential needs of hematopoietic cell transplant (HCT) survivors at least 1-year post-transplant.MethodsA multidisciplinary team met regularly to develop a screening measure to better understand the ongoing medical and clinical symptoms experienced by survivors of HCT. This measure was given to 299 patients presenting to an HCT survivorship clinic, with referrals offered for any issues reaching clinical threshold. A factor analysis was performed to examine the underlying factor structure of the measure.ResultsAnalyses indicated a 3-factor underlying structure, including physical, emotional, and practical concerns. Areas most consistently endorsed as ongoing areas of concern included fatigue, financial concerns, and worry about their future. Interestingly, while many patients were interested in referrals for these issues, some patients did not wish to have their symptoms managed at our center.ConclusionsSurvivors of hematopoietic cell transplant continue to experience symptoms well after their treatment has ended, including issues related to the emotional, physical, and practical impact of their illness and treatment regimen. It is vital that their providers understand the frequency of these concerns as well as patients’ preference for intervention.Implications for cancer survivorsWhile HCT has become increasingly successful in treating hematologic cancers, many survivors experience a range of issues post-transplant. Survivorship care for these patients must include ongoing thorough assessment related to the practical, emotional, and medical symptoms experienced post-transplant, with appropriate intervention provided in-house where possible or in the community according to patient preference.

Little is known about the specific patterns of adjustment among newly diagnosed acute leukemia patients and their caregivers. This study examined the trajectories of patient and caregiver distress over time as well as the extent to which marital satisfaction and social support moderated these trajectories among those with significant-other caregivers. Forty six patient-caregiver dyads provided ratings at four time points: within 1 week of diagnosis (T1), 2 week follow-up (T2), 6 week follow-up (T3) and 12 week follow-up (T4). As anticipated, patients and caregivers reported higher levels of distress around the time of diagnosis than they did during subsequent time points. Marital satisfaction was a significant predictor of distress among patients, whereas among caregivers, social support predicted distress and quality of life. Results support the inclusion of relational variables such as social support and relationship satisfaction in the assessment of newly diagnosed patients and families in order to best identify those at risk for distress over time.

Introduction Several models for survivorship care are prominent within the cancer literature; however, there is little empirical research that examines what oncology clinicians perceive to be the best approach to caring for cancer survivors, what services survivorship programs should include, and how prepared they feel to care for cancer survivors. Methods An IRB approved web-based survey of all clinical staff was conducted at a NCI designated comprehensive cancer center with a 49.8% response rate ( N  = 377). Data were summarized using frequencies and relative frequencies, and pairwise tests of statistical significance were utilized to evaluate differences between clinician type groups. Results Overall, the largest proportion of respondents preferred a disease-specific survivorship model (37.6%). This preference was specifically observed in oncology physicians and nurses. When asked where specific survivorship services should be provided, respondents indicated a preference for services directly related to survivors’ medical treatment (i.e. information about late effects) to be delivered in a disease-specific survivorship clinic, and ancillary services (i.e. nutrition and fertility counseling) to be housed in a centralized comprehensive survivorship clinic. Physicians felt that they have significantly more information, training, and resources to care for cancer survivors than did oncology nurses. Discussion/conclusion These results indicate that oncology clinicians prefer a combination of survivorship care delivery models where continuing medical needs are met in disease-specific clinics, and comprehensive wellness services are offered in a centralized comprehensive survivorship clinic. Results also suggest that planning for survivorship initiatives should include additional resources, education, and training for clinical staff. Implications for cancer survivors These findings underscore the need for a universally accepted definition of cancer survivorship, and support a model for delivering care to cancer survivors that is a blend of the disease-specific and comprehensive survivorship programs.

Despite the well-documented role of psychosocial factors in the use of medical services and treatment compliance (Ford, Trestman, Steinberg, Tennen, & Allen, 2004; Groessl & Cronan, 2000), social workers in medical settings frequently confront an array of challenges to integrating social work services in support of patients (Carlson et al., 2004; Gregorian, 2005). Many of these obstacles result from the difficulties inherent in establishing psychosocial assessment, referral, and treatment programs in an environment that focuses primarily on the delivery of medical care. The compelling need to manage patients' medical situations often leads to an underappreciation of the direct benefits resulting from meeting the psychosocial needs of patients and their families. These challenges are particularly intense in medical settings that specialize in the diagnosis and treatment of life-threatening diseases such as cancer. A cancer diagnosis and the resulting treatment result in high levels of stress for both the patient and the family (Hoffman, Zevon, D'Arrigo, & Cecchini, 2004; Jacobsen, 2006). However, in spite of this well-known outcome, less than 10 percent of newly diagnosed cancer cases in the United States are referred for psychosocial assistance (Kadan-Lottick, Vanderwerker, Block, Zhang, & Prigerson, 2005). In fact, there is no minimum standard for psychosocial care included in the Patient's Bill of Rights (HealthReform.gov, 2010). Adapted from the source document.

CHEMOTHERAPEUTIC agents are used frequently in the treatment of children and adolescents with cancer. Many of these agents are mutagenic, with the potential to cause injury to germ-cell chromosomes. The possible results of this injury include an increase in the frequency of genetic diseases and congenital anomalies in the children subsequently born to patients successfully treated for cancer during childhood and adolescence. Several studies of the children of patients previously treated for diverse types of childhood cancer identified no increase in the frequency of congenital anomalies in the children. 1 2 3 Although previous reports of studies of the children of patients treated . . .

Two multiple category item response theory models are compared using a data set of 52 mood terms with 713 subjects. Tellegen’s (1985) model of mood with two independent, unipolar dimensions of positive and negative affect provided a theoretical basis for the assumption of unidimensionality. Principle components analysis and item parameter tests supported the unidimensionality assumption. Comparative model data fit for the Samejima (1969) logistic model for graded responses and the Masters (1982) partial credit model favored the former model for this particular data set. Theoretical and practical aspects of the comparative application of multiple category models in the measurement of subjective well-being or mood are discussed.

Two multiple category item response theory models are compared using a data set of 52 mood terms with 713 subjects. Tellegen's (1985) model of mood with two independent, unipolar dimensions of positive and negative affect provided a theoretical basis for the assumption of unidimensionality. Principle components analysis and item parameter tests supported the unidimensionality assumption. Comparative model data fit for the Samejima (1969) logistic model for graded responses and the Masters (1982) partial credit model favored the former model for this particular data set. Theoretical and practical aspects of the comparative application of multiple category models in the measurement of subjective well-being or mood are discussed.