Melissa Henry

The Meaning‐Making intervention (MMi) appears to increase meaning in life in advanced ovarian cancer: a randomized controlled pilot study

Objective: This pilot study aimed to provide supportive evidence for the acceptability and usefulness of the Meaning‐Making intervention (MMi) in patients newly diagnosed with Stage III or IV ovarian cancer, and to provide estimates of parameters needed to design a full‐scale study.

Head and neck cancer patients want us to support them psychologically in the posttreatment period: Survey results.

OBJECTIVES No study systematically has investigated the supportive care needs of general head and neck cancer patients using validated measures. These needs include physical and daily living needs, health system and information needs, patient care and support needs, psychological needs, and sexuality needs. Identifying the unmet needs of head and neck cancer patients is a necessary first step to improving the care we provide to patients seen in our head and neck oncology clinics. It is recommended as the first step in intervention development in the Pan-Canadian Clinical Practice Guideline of the Canadian Partnership Against Cancer (see Howell, 2009). This study aimed to identify: (1) met and unmet supportive care needs of head and neck cancer patients, and (2) variability in needs according to demographics, disease variables, level of distress, and quality-of-life domains. METHODS Participants were recruited from the otolaryngology-head and neck surgery clinics of two university teaching hospitals. Self-administered questionnaires included sociodemographic and medical questions, as well as validated measures such as the Supportive Care Needs Survey-Short Form (SCNS-SF34), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General (FACT-G) and Head and Neck Module (FACT-H&N) (quality of life measures). RESULTS One hundred and twenty-seven patients participated in the survey. 68% of them experienced unmet needs, and 25% revealed a clinically significant distress level on the HADS. The highest unmet needs were psychological (7 of top 10 needs). A multiple linear regression indicated a higher level of overall unmet needs when patients were divorced, had a high level of anxiety (HADS subscale), were in poor physical condition, or had a diminished emotional quality of life (FACT-G subscales). SIGNIFICANCE OF RESULTS The results of this study highlight the overwhelming presence of unmet psychological needs in head and neck cancer patients and underline the importance of implementing interventions to address these areas perceived by patients as important. In line with hospital resource allocation and cost-effectiveness, one may also contemplate screening patients for high levels of anxiety, as well as target patients who are divorced and present low levels of physical well-being, as these patients may have more overall needs to be met.

Impact of a short yoga intervention on medical students’ health: A pilot study

Background: Medical students often experience significant distress early-on in undergraduate training. Aims: We aimed to demonstrate the impact of a brief structured yoga intervention on medical students. Method: Fourteen first-year medical students participated in a 16-week yoga intervention pilot study. Students completed questionnaires at baseline, mid-intervention and end of the study. Results: The students reported improvements in overall health, perceived stress and depressive symptoms following the intervention. Conclusions: A yoga intervention may be effective in decreasing stress and improving general well-being in medical students.

What are thyroidectomy patients really concerned about

Objective. To better appreciate perioperative concerns affecting patients considering thyroidectomy and to understand how they may vary according to patient characteristics. Study Design. Cross-sectional analysis. Setting. Tertiary referral center. Subjects and Methods. The authors recruited patients scheduled for thyroid surgery at the McGill University Thyroid Cancer Center. A total of 148 patients completed the 18-item Western Surgical Concern Inventory–Thyroid (WSCI-T) questionnaire. Psychometrics of the WSCI-T were assessed through a principal component analysis with varimax rotation and reliability analyses. Independent-samples t tests and 2-tailed Pearson correlations were ran, identifying areas of elevated concerns and their relationship to gender, age, and surgical procedure (total vs hemithyroidectomy). Results. The principal component analysis revealed the presence of 3 domains of presurgical concerns on the WSCI-T: Surgery-Related Concerns, Psychosocial Concerns, and Daily-Living Concerns. Reliability coefficients for the WSCI-T Total and subscales were satisfactory. Responses on the WSCI-T indicated on average a moderate overall level of concerns before thyroidectomy. Surgery-Related Concerns was the highest domain of concerns, followed by Daily-Living and Psychosocial Concerns, respectively. Patients were mainly worried about the nodule being cancerous, experiencing a change in voice, and surgical complications. Areas of minor concern included being judged or treated differently, becoming depressed, and feeling embarrassed. Women had higher overall levels of concern than men did. Although there were no significant differences in overall levels of concern according to age and surgical procedure, differences were noted at a subscale and item level. Conclusion. This study establishes a mean that will permit adequate physician counseling and a better management of patients’ perioperative worries.

Means to Meaning in Cancer-Related Bereavement Identifying Clinical Implications for Counseling Psychologists

The search for meaning in bereavement is a topic of increasing scholarly interest. Nonetheless, literature has not yet appeared that examines the intersections of diverse theories of meaning, corresponding empirical findings, and clinical implications for counseling psychologists engaged in cancer-related bereavement psychotherapy. Meaning theories drawn from several domains of scholarship including existential, spirituality, stress, and bereavement are surveyed followed by a review of related empirical trends in the scholarship. A hypothetical case vignette is then presented to highlight potential strategies for counseling psychologists to integrate a broadened meaning-based approach to bereavement psychotherapy related to the loss of a loved one from cancer. The article concludes by identifying limitations of a meaning-based approach, as well as directions for further research.

The psychological impact of a cancer diagnosed during pregnancy: determinants of long-term distress.

Background: Cancer occurs during one in 1000–5000 of the approximately 6 million yearly US pregnancies identified by the American Pregnancy Association. Although a newly diagnosed cancer is associated with substantial distress, little is known about cancers emotional impact on women when diagnosed during pregnancy, and no studies have been conducted on the subject.

Continued study of the psychometric properties of the McGill quality of life questionnaire.

The McGill Quality of Life Questionnaire (MQOL) is a widely used tool that has been specifically developed to measure the quality of life of patients facing a life-threatening illness. Preferably, a self-report instrument has an equal number of items worded positively and negatively. However, all the psychological scales of the MQOL are worded so that a high score is negative, whereas the existential scales are worded so that a high score is positive. The goal of this study was to investigate the influence of MQOL item formatting on patient responses. In order to do so, a modified version of the questionnaire was distributed to and completed by 205 patients in two oncology clinics. The modified version had an equal amount of items worded in a positive direction and negative direction in each of the domains. Results of this study were found to be different from those of other studies: the loading of the items was partly based on scale direction. These changes support the idea that the MQOL formatting has some impact on patient responses. However, factors were also determined by content. Given that MQOL has been widely used and the original formatting provides conceptually clearer subscales, we suggest maintaining the original format, keeping in mind the effect of formatting when interpreting scores.

Meaning-based group counseling for bereavement: bridging theory with emerging trends in intervention research.

A growing body of scholarship has evaluated the usefulness of meaning-based theories in the context of bereavement counseling. Although scholars have discussed the application of meaning-based theories for individual practice, there is a lack of inquiry regarding its implications when conducting bereavement support groups. The objective of this article is to bridge meaning-based theories with bereavement group practice, leading to a novel intervention and laying the foundation for future efficacy studies. Building on recommendations specified in the literature, this article outlines the theoretical paradigms and structure of a short-term meaning-based group counseling intervention for uncomplicated bereavement.

Reconstructing Meaning with Others in Loss: A Feasibility Pilot Randomized Controlled Trial of a Bereavement Group.

More effective psychosocial interventions that target uncomplicated bereavement are needed for those actively seeking support. The objective of this study was to assess the feasibility of evaluating a unique meaning-based group counseling (MBGC) intervention with a randomized controlled trial (RCT) design. Twenty-six bereft individuals were randomly assigned to either MBGC or a control bereavement support group. Twenty participants (11 experimental, nine control) completed all aspects of the study including self-report measures at baseline, postintervention, and 3-month follow-up of meaning in life, anxiety, depression, and grief. Results support the feasibility of an RCT with MBGC.

A Pilot Study of Meaning-Based Group Counseling for Bereavement

Scientific studies demonstrating either the efficacy or effectiveness of interventions for uncomplicated bereavement are lacking. This study reports the results of a novel meaning-based group counseling (MBGC) intervention developed for bereaved adults. MBGC was built on previous scholarly critiques using a formative evaluation methodology within a group of bereaved adults (n = 11). The primary research questions were as follows: (a) How do bereft individuals respond to MBGC? and (b) What refinements are needed to MBGC to ensure feasibility? A secondary research question was: (c) Is collection of quantitative outcome measures at baseline and postintervention feasible? Analysis of multiple qualitative data sources resulted in numerous refinements to MBGC. Results indicate that the majority of participants found the meaning-based intervention beneficial. Limitations included concurrent external therapies and a small sample size that was largely homogenous. There were no major counterindications to proceeding with a pilot randomized controlled trial (RCT).