Benjamin Tallman

Sexual functioning in patients undergoing bone marrow transplantation: a longitudinal study.

Patients undergoing bone marrow transplantation (BMT) reported numerous sexual difficulties pretransplantation and at 1- and 3-years post transplantation. The most commonly reported problems pretransplant were a lack of sexual interest for men and self-perceived unattractiveness for women. At year 1, men reported more concern about physical attractiveness and increased problems with erection, ejaculation and orgasm. Women reported more sexual problems across all categories. At year 3, difficulties for men remained relatively consistent or decreased compared to year 1 with the exception of an increased concern about physical appearance. At year 3, women reported increased sexual interest; concerns about body appearance, vaginal dryness, painful intercourse and orgasm remained higher than at baseline, although all had decreased from year 1. Half of patients at all time points reported no discussion of sexuality with their health care provider. Baseline level of depression was significantly and positively related to sexual functioning at year 3 post transplant. These results suggest that sexual problems are significant for BMT survivors and that treatment of depression and health-care-provider education are possible interventional targets for improving sexual function and quality of life following BMT.

College Student Suicide: A Call To Action

This article examines current issues related to the topic of college student suicide and why it continues to be an issue of major concern. The nature/extent of the problem, risk and protective factors, responses to college student suicide, legal issues, and training issues are discussed. The importance of addressing the issue of college student suicide and its prevention on college campuses is emphasized as is the importance of protective factors. Although more is being done to address this issue than has been done in the past, it remains a major concern, and it is an issue that requires a strong national response.

Finding Benefit from Cancer.

Being diagnosed with and treated for cancer is a traumatic experience. Many cancer patients undergoing treatment manifest psychological distress and physical impairment. But this experience may also serve as a stimulus for positive growth. A growing body of literature addresses the possibility of positive growth through difficult events, a concept known as finding benefit. In the current study, the authors investigate finding benefit among 56 adult cancer patients over a period of 3 years, examining the role of optimism and the effects of finding benefit on later depression and physical functioning. The results demonstrated that finding benefit 1 year after treatment was related to both depression and physical functioning at a 3-year follow-up.

Well-being and posttraumatic growth in unrelated donor marrow transplant survivors: A nine-year longitudinal study.

OBJECTIVE To study posttraumatic growth and psychological and physical well-being among 25 cancer survivors (12 men, 13 women) 9 years after receiving a hematopoietic stem cell transplant from an unrelated donor. MEASURES Participants completed measures of well-being (e.g., depression, physical function) and posttraumatic growth at the 9-year follow-up. Prior to treatment, optimism, social support, and well-being had been assessed. RESULTS Findings reveal high levels of physical and psychological well-being. Survivors reported posttraumatic growth in several domains, including increased personal strengths and enhanced interpersonal relationships. Higher levels of growth were significantly related to gender and age: Women reported more total posttraumatic growth, and older survivors reported more enhanced spirituality, one domain of growth. Posttraumatic growth and well-being after treatment were predicted by 2 psychosocial variables assessed prior to treatment: dispositional optimism and social support. IMPLICATIONS Although long-term survivors report ongoing physical limitations, they also experience well-being in both physical and psychological domains. Posttraumatic growth is an area of well-being deserving of additional research and clinical attention. In particular, there may be reason to assist survivors to articulate growth as part of ongoing care.

Measuring post-traumatic changes in spirituality/religiosity

Changes in spirituality and religiosity may play a vital role in understanding individuals’ post-traumatic growth, the experience of positive outcomes from difficult or traumatic personal experience. Although assessment of post-traumatic growth has been addressed by the development of several measures, these measures fail to capture the domain of spiritual/religious change. In this manuscript, we review 12 quantitative measures of post-traumatic growth, focusing on the degree to which these measures allow an adequate assessment of changes in religiosity and/or spirituality. We consider these concepts in the context of understanding the role of these domains in post-traumatic growth and in facilitating clients’ transitions through adversity.

Influence of coping style on symptom interference among adult recipients of hematopoietic stem cell transplantation.

PURPOSE/OBJECTIVES To investigate the influence of coping style on interference caused by a variety of common post-treatment symptoms after hematopoietic stem cell transplantation. DESIGN Longitudinal; secondary analysis of data from the original study that examined health-related quality-of-life variables (e.g., depression, well-being) in adult patients treated with conventional bone marrow transplantation or depleted T-cell bone marrow transplantation. SETTING Fifteen university medical centers in the United States. SAMPLE 105 adult recipients of hematopoietic stem cell transplantation. METHODS Patients were assessed via telephone-based interviews for coping style at baseline and for symptom interference in daily living six months post-treatment. MAIN RESEARCH VARIABLES Coping style and symptom interference. FINDINGS Neither age nor gender predicted symptom interference, with the exception of chronic graft-versus-host disease, where older patients experienced more interference at six months, and breathing symptoms, for which women experienced more interference than men at six months. Avoidant coping style at baseline predicted increased interference from symptoms, but emotion-focused and instrumental coping styles did not predict decreased interference. CONCLUSIONS A generalized avoidant coping style before treatment increased interference from common cancer symptoms six months after hematopoietic stem cell transplantation. IMPLICATIONS FOR NURSING An intervention to teach alternate coping strategies should be implemented prior to treatment and tested for prevention of symptom-related life interference.

Coping After Bone Marrow Transplantation: The Predictive Roles of Optimism and Dispositional Coping

Bone marrow transplantation (BMT) is an invasive and taxing treatment for certain cancers. This study investigated the psychological constructs of optimism and dispositional coping and their relative predictive role for situational coping. Participants were 85 cancer patients enrolled in a randomized clinical trial of T-cell depletion for prevention of graft-versus-host disease (GVHD) who completed baseline and 1-year interviews. Results of simultaneous regression analyses showed that optimism did not predict situational instrumental or palliative coping strategies but was negatively predictive of situational avoidant coping. Each of the three situational coping strategies was most strongly predicted by the corresponding dispositional coping strategy.

Spiritual growth and decline among patients with cancer.

PURPOSE/OBJECTIVES To investigate spiritual transformation among patients with cancer. DESIGN Longitudinal. SETTING A university medical center in the midwestern United States. SAMPLE 47 adult cancer survivors. METHODS Patients were asked about spirituality, religious and spiritual importance, religious coping, and spiritual gain and decline at baseline as well as nine months post-treatment. MAIN RESEARCH VARIABLES Religious importance, religious coping, and spiritual gain or decline. FINDINGS Positive religious coping at baseline predicted spiritual growth at the nine-month follow-up point. Spiritual decline was predicted by negative religious importance. A bivariate relationship existed between increased levels of negative religious coping and increased spiritual growth. CONCLUSIONS Positive religious coping strategies may influence spiritual transformation. IMPLICATIONS FOR NURSING Healthcare providers who support a strengths-based perspective on human functioning may be equipped to perform research on spiritual or religious interventions for patients with cancer. KNOWLEDGE TRANSLATION Greater use of spiritual resources, even if conceptualized as negative religious coping mechanisms or initial spiritual decline, may contribute to increased levels of spiritual growth later. When acting as expert companions, healthcare providers may facilitate spiritual growth by addressing spiritual transformation, creating safe environments for exploring spirituality, becoming familiar with different religious faiths, and seeking appropriate consultation and referrals for patients.

The Oregon Death with Dignity Act: The Right to Live or the Right to Die?

Two hundred six individuals were surveyed concerning their views about the Oregon Death with Dignity Act, which allows for physician-assisted suicide under certain conditions. Results indicated extensive heterogeneity and strong opinions concerning the act. Implications are discussed.