Rosemary R. Lichtman

Attributions, Beliefs About Control, and Adjustment to Breast Cancer

Attributions for cancer and beliefs about control over cancer were examined for their association with adjustment to breast cancer. Although 95% of the respondents made attributions for their cancer, no particular attribution (e.g., stress, diet) was associated with better adjustment. Analyses of attributions of responsibility for the cancer to the self, environment, another person, or chance yielded only a negative relation between adjustment and blaming another person. In contrast, both the belief that one could now control ones cancer and the belief that others (e.g. the physician) could now control the cancer were significantly associated with good adjustment. Of the different types of control, cognitive control was most strongly associated with adjustment, behavior control was less strongly associated with adjustment, and information control and retrospective control were unassociated with adjustment. The theoretical and practical implications of these results are discussed.

Illness‐related and treatment‐related factors in psychological adjustment to breast cancer

Seventy‐eight breast cancer outpatients were interviewed and their medical records were reviewed to document illness‐related and treatment‐related factors associated with psychosocial adjustment. Poor prognosis and more radical surgery both independently predicted poor psychological adjustment. The effect of type of surgery appeared to be mediated by the patients sense of disfigurement and by changes in the sexual and affectional patterns in the marriage, rather than by prognosis or disability. Degree of dysfunction and whether or not the patient had radiation therapy or chemotherapy had no independent effects on psychological adjustment. Results point to the problematic psychosocial outcomes associated with mastectomy and, more generally, to the illness‐ and treatment‐related factors that may place a breast cancer patient at risk for psychosocial adjustment problems.

Close Relationships and the Female Cancer Patient

Nearly one out of every three Americans will contract cancer during his or her lifetime (American Cancer Society, 1985). Consequently, three Out of every four families will be affected, and virtually every individual will be involved in at least one close relationship with a cancer patient. A close relationship involves strong and frequent interdependent interactions in diverse areas of life and lasts over a considerable period of time (Kelley et al., 1983). Typically, this definition includes a person’s spouse or lover, other family members, and close friends. Because cancer is a chronic disease, family and friends are necessarily pulled into the process of coping with the disease.

Equity and the Allocation of Health Care Resources: Proposition or Oxymoron?

The rate of changes in the allocation of health care resources has escalated in the past decade in an attempt to provide for cost containment and a more equitable distribution while retaining quality of care. In this issue, economists, physicians, psychologists, and sociologists examine the current health care environment for evidence relevant to the effect of these changes and provide a guideline for future direction.