Amanda C. Kracen

Vicarious traumatization and secondary traumatic stress: A research synthesis∗

Vicarious traumatization (VT) refers to harmful changes that occur in professionals’ views of themselves, others, and the world, as a result of exposure to the graphic and/or traumatic material of their clients. Secondary traumatic stress (STS) refers to a set of psychological symptoms that mimic post-traumatic stress disorder, but is acquired through exposure to persons suffering the effects of trauma. Numerous studies have sought to identify correlates of both VT and STS, yet there still exists a lack of conceptual clarity in the literature about VT, STS, and the related constructs of burnout and compassion fatigue. This has made it difficult to use the literature to inform practice and training. This study clarifies the definitions of VT and STS and uses levels of evidence analysis to synthesize the research findings to date. Originally planned as a meta-analysis, the study was re-designed as methodological issues in the literature became apparent that would call into question the validity of a meta-analysis. The current method of analysis documents the degree of evidence for the most commonly researched factors that have been researched as possible contributors to the development of both VT and STS, synthesizing the findings of published research and dissertations written in the English language from 1994–2003. Findings indicate that persuasive evidence exists for personal trauma history, reasonable evidence for perceived coping style, and some evidence for supervision experiences, as important predictors of VT. Persuasive evidence for amount of exposure to trauma material and reasonable evidence for personal trauma history are indicated as important in the development of STS. Limitations of the current study and directions for further research are discussed. *An earlier version of this paper was presented at the 112th Annual Conference of the American Psychological Association, 31 July 2004, Honolulu Hawaii, USA

Fruit and Vegetable Dietary Behavior in Response to a Low-Intensity Dietary Intervention: The Rural Physician Cancer Prevention Project

CONTEXT Increased fruit and vegetable intake can reduce cancer risk. Information from this study contributes to research exploring health disparities in high-risk dietary behavior. PURPOSE Changes in fruit and vegetable behavior were evaluated to assess the effects of a low-intensity, physician-endorsed dietary intervention in a rural population. METHODS The study was a randomized trial of 754 patients from 3 physician practices in rural Virginia. Low-literacy nutrition education materials and personalized dietary feedback were administered by mail and telephone. Mixed model analysis of variance was used to determine the effect of the intervention on fruit and vegetable intake behavior, knowledge, intentions, and self-efficacy at 1, 6, and 12 months. FINDINGS The intervention effect was moderated by age, race, sex, and education. Intake at 1 and 6 months was increased for older and younger participants and those with some college, and further maintained at 12 months by those who did not complete high school. African Americans in the intervention group displayed significantly greater intentions to increase fruit/vegetable intake than whites/others. Knowledge of fruit/vegetable recommendations significantly increased in the intervention group at 12 months, particularly for men. CONCLUSIONS For the rural population, a low-intensity physician-endorsed self-help dietary intervention was successful in initiating fruit and vegetable dietary changes at 1 and 6 months post-intervention, and increasing intentions to change in African Americans. The relationship of the moderating effects of age, race, sex and education need to be further explored in relation to dietary intervention and dietary behavior change for the rural population.

Resilience in adults with cancer: development of a conceptual model.

Resilience is a construct addressed in the psycho‐oncology literature and is especially relevant to cancer survivorship. The purpose of this paper is to propose a model for resilience that is specific to adults diagnosed with cancer.

Cancer-related hair loss: a selective review of the alopecia research literature.

Alopecia is a common side effect of cancer treatment, affecting approximately 65% of patients. Healthcare providers and allied staff recognize that alopecia is distressing for people with cancer; however, they are often unaware of the extent of distress or the great efforts expended by patients to cope with hair loss. This study reviews the existing literature regarding the psychosocial impact of alopecia on cancer survivors and the coping strategies they use to manage hair loss.

Definitely Not a Home Water Birth: 83 Days Awaiting Twins on an Antenatal Unit

aftermath of my baby’s death. There is nothing that I could have done to be better prepared for my loss and I don’t have any wisdom to offer other bereaved mothers. But to clinicians who care for bereaved mothers, I would encourage you to attend to the manner in which my providers cared for me. Beyond receiving excellent medical care, the attention that was given to my psychological wellbeing was remarkable. I am grateful that my doctors and nurses knew when to respect my wishes and how to help me when I did not know what was in my best interest. The care that I received at their hands enabled me to survive when my baby did not.

Psychosocial staffing at National Comprehensive Cancer Network member institutions: data from leading cancer centers

The National Comprehensive Cancer Network (NCCN) is comprised of 25 National Cancer Institute‐designated cancer centers and arguably could thus set the standard for optimal psychosocial staffing for cancer centers; therefore, information was sought from NCCN Member Institutions about their current staffing for psychosocial services. These findings are put into perspective given the limited existing literature and consensus reports.

Oncologists' mindfulness, health, well-being, and patient care.

e16527 Background: Occupational demands on oncologists continue. Burnout is a serious concern, especially considering the looming shortage of oncologists. There is scant research regarding oncologi...