, except for brief excerpts in connection with reviews or scholarly analysis. Use in connection w... more , except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Journal of the National Comprehensive Cancer Network, 2017
Background: This study examined the extent to which cancer programs demonstrated adherence to the... more Background: This study examined the extent to which cancer programs demonstrated adherence to their own prescribed screening protocol, and whether adherence to that protocol was associated with medical service utilization. The hypothesis is that higher rates of service utilization are associated with lower rates of adherence to screening protocols. Methods: Oncology social workers at Commission on Cancer-accredited cancer programs reviewed electronic health records (EHRs) in their respective cancer programs during a 2-month period in 2014. Rates of overall adherence to a prescribed distress screening protocol were calculated based on documentation in the EHR that screening adherence and an appropriate clinical response had occurred. We examined documentation of emergency department (ED) use and hospitalization within 2 months after the screening visit. Results: Review of 8,409 EHRs across 55 cancer centers indicated that the overall adherence rate to screening protocols was 62.7%. The highest rates of adherence were observed in Community Cancer Programs (76.3%) and the lowest rates were in NCI-designated Cancer Centers (43.3%). Rates of medical service utilization were significantly higher than expected when overall protocol adherence was lacking. After controlling for patient and institutional characteristics, risk ratios for ED use (0.82) and hospitalization (0.81) suggest that when overall protocol adherence was documented, 18% to 19% fewer patients used these medical services. Conclusions: The observed associations between a mandated psychosocial care protocol and medical service utilization suggest opportunities for operational efficiencies and costs savings. Further investigations of protocol integrity, as well as the clinical care models by which psychosocial care is delivered, are warranted.
Objective-The majority of adults sleep with a partner making sleep a dyadic experience. However, ... more Objective-The majority of adults sleep with a partner making sleep a dyadic experience. However, interventions to improve sleep have primarily focused on individuals. This qualitative analysis used a dyadic approach to identify facilitators and barriers to successful treatment of one of the most common sleep disorders, obstructive sleep apnea, with continuous positive airway pressure (CPAP). Methods-Twenty joint qualitative interviews were conducted with couples, one couple at a time, with a sample of 20 patients with obstructive sleep apnea and their partners to develop an understanding of couples' experiences with CPAP use. Interviews were audio recorded and transcribed. Conventional qualitative content analysis was used to analyze the interview data. Results-Facilitators of CPAP use were: the partner aiding diagnosis and treatment, couples working together using CPAP, the perceived benefits of CPAP for both partners, the patient being motivated to use CPAP for the benefit of the partner, and various types of support provided by the partner to encourage CPAP use. Major barriers to CPAP use were: anxiety related to CPAP use particularly in the beginning of therapy, bothersome equipment causing disruptions in sleep and bedtime routine, interruptions to intimacy, and concern about image change while wearing CPAP.
Background: Although it is known both patients' and partners' reactions to a prostate cancer diag... more Background: Although it is known both patients' and partners' reactions to a prostate cancer diagnosis include fear, uncertainty, anxiety and depression, with patients' and partners' reactions mutually determining how they cope with and adjust to the illness, few psychosocial interventions target couples. Those that are available tend to be led by highly trained professionals, limiting their accessibility and long-term sustainability. In addition, it is recognised that patients who might benefit from conventional face-to-face psychosocial interventions do not access these, either by preference or because of geographical or mobility barriers. Self-directed interventions can overcome some of these limitations and have been shown to contribute to patient well-being. This study will examine the feasibility of a self-directed, coping skills intervention for couples affected by cancer, called Coping-Together, and begin to explore its potential impact on couples' illness adjustment. The pilot version of Coping-Together includes a series of four booklets, a DVD, and a relaxation audio CD. Methods/design: In this double-blind, two-group, parallel, randomized controlled trial, 70 couples will be recruited within 4 months of a prostate cancer diagnosis through urology private practices and randomized to: 1) Coping-Together or 2) a minimal ethical care condition. Minimal ethical care condition couples will be mailed information booklets available at the Cancer Council New South Wales and a brochure for the Cancer Council Helpline. The primary outcome (anxiety) and additional secondary outcomes (distress, depression, dyadic adjustment, quality of life, illness or caregiving appraisal, self-efficacy, and dyadic and individual coping) will be assessed at baseline (before receiving study material) and 2 months post-baseline. Intention-to-treat and per protocol analysis will be conducted. Discussion: As partners' distress rates exceed not only population norms, but also those reported by patients themselves, it is imperative that coping skills interventions target the couple as a unit and enhance both partners' ability to overcome cancer challenges. This pilot study will examine the feasibility and potential efficacy of Coping-Together in optimising couples' illness adjustment. This is one of the first feasibility studies to test this innovative coping intervention, which in turn will contribute to the larger literature advocating for psychosocial care of couples affected by prostate cancer.
incontinence, sexual dysfunction) that challenge the patient's sense of masculinity and identity,... more incontinence, sexual dysfunction) that challenge the patient's sense of masculinity and identity, [2-4] impact upon life satisfaction, and reduce mental and social well-being. [5,6] While prostate cancer is exclusively a male disease, it is also argued that, for partnered men, it could be considered a "relational disease" [7] due to the significant impact that the physical and psychosocial consequences may have on intimate relationships. In addition, Galbraith et al. [8] have demonstrated the strong interrelationship between patient and partner health-related quality of life for couples experiencing prostate cancer, suggesting mutuality in response to the disease and its treatment, and therefore highlighting the need to consider both members of a dyad throughout the cancer journey. Objective: To (a) determine whether the information provided to men with prostate cancer and their partners in the immediate postdiagnostic phase met their needs; and (b) examine patient and partner satisfaction with the information received. Methods: Pre-intervention survey data from a pilot randomized controlled trial of a self-directed coping skills intervention involving 42 patients with prostate cancer, and their partners were collected to examine their psychosocial concerns/needs. Results: The main concerns for patients and partners were psychosocial in nature such as managing emotions, concern about the future, and losing control. Overall, patients and partners received most information about tests and treatment options. Partners reported receiving significantly less information about support services (P = 0.03) and self-care strategies (P = 0.03) compared to patients. Partners also reported being significantly less satisfied with the information they received (P = 0.007). Conclusions: Whereas medical information is routinely given, patients and partners may benefit from greater information about psychosocial issues arising from cancer. Despite increased recognition of partner's information needs these still remain unmet.
... AN INVENTORY FOR ASSESSING EMOTIONAL ESTRANGEMENT IN MARRIAGE KAREN KAYSER ... In addition, l... more ... AN INVENTORY FOR ASSESSING EMOTIONAL ESTRANGEMENT IN MARRIAGE KAREN KAYSER ... In addition, lack of love is one of the most frequently cited reasons for divorce (Albrecht et al., 1983; Bloom & Hodges, 1981; Kingsbury & Minda, 1988). ...
Background: Interprofessional education is necessary to prepare students of the health profession... more Background: Interprofessional education is necessary to prepare students of the health professions for successful practice in today's health care environment. Because of its expertise in interdisciplinary practice and team-based care, palliative care should be leading the way in creating educational opportunities for students to learn the skills for team practice and provision of quality patient-centered care. Multiple barriers exist that can discourage those desiring to create and implement truly interdisciplinary curriculum. An interdisciplinary faculty team planned and piloted a mandatory interdisciplinary palliative oncology curriculum and responded to formative feedback. The project took place at a large public metropolitan university. Medical, nursing, and social work students and chaplains completing a clinical pastoral education internship participated in the curriculum. Formative feedback was received via the consultation of an interdisciplinary group of palliative educ...
During my experience as a clinician working with couples, I have been fascinated with and challen... more During my experience as a clinician working with couples, I have been fascinated with and challenged by the phenomenon of" falling out of love." A common occurrence in therapy is one of the spouses announcing during the initial session," I want out." With further ...
Previous studies have revealed that the ways couples deal with stress in their lives are signific... more Previous studies have revealed that the ways couples deal with stress in their lives are significantly associated with their marital quality and overall marital functioning. However, there has been little empirical evidence linking dyadic coping with marital quality over time. This study addresses the relationship between dyadic coping and marital quality among 90 couples over a period of 2 years. The results reveal that dyadic coping was significantly associated with marital quality over 2 years. For women, both their own dyadic coping and that of their partner were significant predictors, whereas for men only their own dyadic coping was predictive. The results are discussed with regard to prevention of marital distress.
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
This paper presents findings on how breast cancer patients and their partners cope to-gether with... more This paper presents findings on how breast cancer patients and their partners cope to-gether with the cancer diagnosis and treat-ment. It expands on earlier frameworks of dyadic coping by presenting a model that views dyadic coping as a process that varies according to how ...
The psychological and social consequences of having a diagnosis of cancer can continue beyond the... more The psychological and social consequences of having a diagnosis of cancer can continue beyond the initial year of diagnosis. However, very few empirical studies examine the long-term adjustment of cancer survivors and the factors that promote survivors' well-being. This paper presents an 18 month follow-up study of 26 women who were treated for various types of cancer at a major medical center in the United States. They completed questionnaires during the initial treatment phase of the illness and 18 months later. The questionnaire consisted of standardized scales measuring relationship factors (i.e., mutuality, silencing-the-self schemas, and relationship-focused coping) and psychosocial well-being (i.e., quality of life, depression, self-care agency). The results of the follow-up study revealed that the women's psychosocial well-being changed for the better between Time 1 and Time 2, while their relationship factors remained constant. Only one relational factor, silencing-the-self beliefs, at Time 1, was significantly correlated with a well-being variable at Time 2. However, relationship factors at Time 2 were significantly correlated with psychosocial well-being at Time 2, indicating that relational factors continue to play a significant role in the sample's psychosocial adjustment.
Social workers in hospitals are often involved in family conferences where patient, family member... more Social workers in hospitals are often involved in family conferences where patient, family members and hospital personnel meet together to exchange information about the patient's condition and to plan for the future. In this paper the complexities of these meetings as decision making arenas are discussed and an outline of the three phases of family conferences--preparation, the conference meeting and follow up--is presented. The final section reports on an exploratory review of recent conferences as perceived by social workers from an acute and rehabilitation teaching hospital. The social workers' comments indicate that the conferences achieve the desired outcomes, especially for hospital staff. In this hospital the conferences are more often used for providing family members with information, and for collective decision making about the patient's future care, than for providing information to the patients about their illness and treatment.
To understand fully how a woman copes with cancer, researchers must examine the relational contex... more To understand fully how a woman copes with cancer, researchers must examine the relational context in which a woman lives, copes, and meets the demands of a life-threatening illness. This paper presents preliminary findings of a study involving thirty-four mothers who have cancer. Survey methods involving a questionnaire were used to look at the relationship of the factors of mutuality, silencing the self schemas, and relationship-focused coping to the psychosocial adaptation to cancer. The findings indicated a significant correlation between silencing the self schemas and health care behaviors. Correlations between mutuality and quality of life approached statistical significance. Based on these findings, suggestions for social work practice with cancer patients and their families are made.
, except for brief excerpts in connection with reviews or scholarly analysis. Use in connection w... more , except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Journal of the National Comprehensive Cancer Network, 2017
Background: This study examined the extent to which cancer programs demonstrated adherence to the... more Background: This study examined the extent to which cancer programs demonstrated adherence to their own prescribed screening protocol, and whether adherence to that protocol was associated with medical service utilization. The hypothesis is that higher rates of service utilization are associated with lower rates of adherence to screening protocols. Methods: Oncology social workers at Commission on Cancer-accredited cancer programs reviewed electronic health records (EHRs) in their respective cancer programs during a 2-month period in 2014. Rates of overall adherence to a prescribed distress screening protocol were calculated based on documentation in the EHR that screening adherence and an appropriate clinical response had occurred. We examined documentation of emergency department (ED) use and hospitalization within 2 months after the screening visit. Results: Review of 8,409 EHRs across 55 cancer centers indicated that the overall adherence rate to screening protocols was 62.7%. The highest rates of adherence were observed in Community Cancer Programs (76.3%) and the lowest rates were in NCI-designated Cancer Centers (43.3%). Rates of medical service utilization were significantly higher than expected when overall protocol adherence was lacking. After controlling for patient and institutional characteristics, risk ratios for ED use (0.82) and hospitalization (0.81) suggest that when overall protocol adherence was documented, 18% to 19% fewer patients used these medical services. Conclusions: The observed associations between a mandated psychosocial care protocol and medical service utilization suggest opportunities for operational efficiencies and costs savings. Further investigations of protocol integrity, as well as the clinical care models by which psychosocial care is delivered, are warranted.
Objective-The majority of adults sleep with a partner making sleep a dyadic experience. However, ... more Objective-The majority of adults sleep with a partner making sleep a dyadic experience. However, interventions to improve sleep have primarily focused on individuals. This qualitative analysis used a dyadic approach to identify facilitators and barriers to successful treatment of one of the most common sleep disorders, obstructive sleep apnea, with continuous positive airway pressure (CPAP). Methods-Twenty joint qualitative interviews were conducted with couples, one couple at a time, with a sample of 20 patients with obstructive sleep apnea and their partners to develop an understanding of couples' experiences with CPAP use. Interviews were audio recorded and transcribed. Conventional qualitative content analysis was used to analyze the interview data. Results-Facilitators of CPAP use were: the partner aiding diagnosis and treatment, couples working together using CPAP, the perceived benefits of CPAP for both partners, the patient being motivated to use CPAP for the benefit of the partner, and various types of support provided by the partner to encourage CPAP use. Major barriers to CPAP use were: anxiety related to CPAP use particularly in the beginning of therapy, bothersome equipment causing disruptions in sleep and bedtime routine, interruptions to intimacy, and concern about image change while wearing CPAP.
Background: Although it is known both patients' and partners' reactions to a prostate cancer diag... more Background: Although it is known both patients' and partners' reactions to a prostate cancer diagnosis include fear, uncertainty, anxiety and depression, with patients' and partners' reactions mutually determining how they cope with and adjust to the illness, few psychosocial interventions target couples. Those that are available tend to be led by highly trained professionals, limiting their accessibility and long-term sustainability. In addition, it is recognised that patients who might benefit from conventional face-to-face psychosocial interventions do not access these, either by preference or because of geographical or mobility barriers. Self-directed interventions can overcome some of these limitations and have been shown to contribute to patient well-being. This study will examine the feasibility of a self-directed, coping skills intervention for couples affected by cancer, called Coping-Together, and begin to explore its potential impact on couples' illness adjustment. The pilot version of Coping-Together includes a series of four booklets, a DVD, and a relaxation audio CD. Methods/design: In this double-blind, two-group, parallel, randomized controlled trial, 70 couples will be recruited within 4 months of a prostate cancer diagnosis through urology private practices and randomized to: 1) Coping-Together or 2) a minimal ethical care condition. Minimal ethical care condition couples will be mailed information booklets available at the Cancer Council New South Wales and a brochure for the Cancer Council Helpline. The primary outcome (anxiety) and additional secondary outcomes (distress, depression, dyadic adjustment, quality of life, illness or caregiving appraisal, self-efficacy, and dyadic and individual coping) will be assessed at baseline (before receiving study material) and 2 months post-baseline. Intention-to-treat and per protocol analysis will be conducted. Discussion: As partners' distress rates exceed not only population norms, but also those reported by patients themselves, it is imperative that coping skills interventions target the couple as a unit and enhance both partners' ability to overcome cancer challenges. This pilot study will examine the feasibility and potential efficacy of Coping-Together in optimising couples' illness adjustment. This is one of the first feasibility studies to test this innovative coping intervention, which in turn will contribute to the larger literature advocating for psychosocial care of couples affected by prostate cancer.
incontinence, sexual dysfunction) that challenge the patient's sense of masculinity and identity,... more incontinence, sexual dysfunction) that challenge the patient's sense of masculinity and identity, [2-4] impact upon life satisfaction, and reduce mental and social well-being. [5,6] While prostate cancer is exclusively a male disease, it is also argued that, for partnered men, it could be considered a "relational disease" [7] due to the significant impact that the physical and psychosocial consequences may have on intimate relationships. In addition, Galbraith et al. [8] have demonstrated the strong interrelationship between patient and partner health-related quality of life for couples experiencing prostate cancer, suggesting mutuality in response to the disease and its treatment, and therefore highlighting the need to consider both members of a dyad throughout the cancer journey. Objective: To (a) determine whether the information provided to men with prostate cancer and their partners in the immediate postdiagnostic phase met their needs; and (b) examine patient and partner satisfaction with the information received. Methods: Pre-intervention survey data from a pilot randomized controlled trial of a self-directed coping skills intervention involving 42 patients with prostate cancer, and their partners were collected to examine their psychosocial concerns/needs. Results: The main concerns for patients and partners were psychosocial in nature such as managing emotions, concern about the future, and losing control. Overall, patients and partners received most information about tests and treatment options. Partners reported receiving significantly less information about support services (P = 0.03) and self-care strategies (P = 0.03) compared to patients. Partners also reported being significantly less satisfied with the information they received (P = 0.007). Conclusions: Whereas medical information is routinely given, patients and partners may benefit from greater information about psychosocial issues arising from cancer. Despite increased recognition of partner's information needs these still remain unmet.
... AN INVENTORY FOR ASSESSING EMOTIONAL ESTRANGEMENT IN MARRIAGE KAREN KAYSER ... In addition, l... more ... AN INVENTORY FOR ASSESSING EMOTIONAL ESTRANGEMENT IN MARRIAGE KAREN KAYSER ... In addition, lack of love is one of the most frequently cited reasons for divorce (Albrecht et al., 1983; Bloom & Hodges, 1981; Kingsbury & Minda, 1988). ...
Background: Interprofessional education is necessary to prepare students of the health profession... more Background: Interprofessional education is necessary to prepare students of the health professions for successful practice in today's health care environment. Because of its expertise in interdisciplinary practice and team-based care, palliative care should be leading the way in creating educational opportunities for students to learn the skills for team practice and provision of quality patient-centered care. Multiple barriers exist that can discourage those desiring to create and implement truly interdisciplinary curriculum. An interdisciplinary faculty team planned and piloted a mandatory interdisciplinary palliative oncology curriculum and responded to formative feedback. The project took place at a large public metropolitan university. Medical, nursing, and social work students and chaplains completing a clinical pastoral education internship participated in the curriculum. Formative feedback was received via the consultation of an interdisciplinary group of palliative educ...
During my experience as a clinician working with couples, I have been fascinated with and challen... more During my experience as a clinician working with couples, I have been fascinated with and challenged by the phenomenon of" falling out of love." A common occurrence in therapy is one of the spouses announcing during the initial session," I want out." With further ...
Previous studies have revealed that the ways couples deal with stress in their lives are signific... more Previous studies have revealed that the ways couples deal with stress in their lives are significantly associated with their marital quality and overall marital functioning. However, there has been little empirical evidence linking dyadic coping with marital quality over time. This study addresses the relationship between dyadic coping and marital quality among 90 couples over a period of 2 years. The results reveal that dyadic coping was significantly associated with marital quality over 2 years. For women, both their own dyadic coping and that of their partner were significant predictors, whereas for men only their own dyadic coping was predictive. The results are discussed with regard to prevention of marital distress.
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
APA PsycNET Our Apologies! - The following features are not available with your current Browser c... more APA PsycNET Our Apologies! - The following features are not available with your current Browser configuration. - alerts user that their session is about to expire - display, print, save, export, and email selected records - get My ...
This paper presents findings on how breast cancer patients and their partners cope to-gether with... more This paper presents findings on how breast cancer patients and their partners cope to-gether with the cancer diagnosis and treat-ment. It expands on earlier frameworks of dyadic coping by presenting a model that views dyadic coping as a process that varies according to how ...
The psychological and social consequences of having a diagnosis of cancer can continue beyond the... more The psychological and social consequences of having a diagnosis of cancer can continue beyond the initial year of diagnosis. However, very few empirical studies examine the long-term adjustment of cancer survivors and the factors that promote survivors' well-being. This paper presents an 18 month follow-up study of 26 women who were treated for various types of cancer at a major medical center in the United States. They completed questionnaires during the initial treatment phase of the illness and 18 months later. The questionnaire consisted of standardized scales measuring relationship factors (i.e., mutuality, silencing-the-self schemas, and relationship-focused coping) and psychosocial well-being (i.e., quality of life, depression, self-care agency). The results of the follow-up study revealed that the women's psychosocial well-being changed for the better between Time 1 and Time 2, while their relationship factors remained constant. Only one relational factor, silencing-the-self beliefs, at Time 1, was significantly correlated with a well-being variable at Time 2. However, relationship factors at Time 2 were significantly correlated with psychosocial well-being at Time 2, indicating that relational factors continue to play a significant role in the sample's psychosocial adjustment.
Social workers in hospitals are often involved in family conferences where patient, family member... more Social workers in hospitals are often involved in family conferences where patient, family members and hospital personnel meet together to exchange information about the patient's condition and to plan for the future. In this paper the complexities of these meetings as decision making arenas are discussed and an outline of the three phases of family conferences--preparation, the conference meeting and follow up--is presented. The final section reports on an exploratory review of recent conferences as perceived by social workers from an acute and rehabilitation teaching hospital. The social workers' comments indicate that the conferences achieve the desired outcomes, especially for hospital staff. In this hospital the conferences are more often used for providing family members with information, and for collective decision making about the patient's future care, than for providing information to the patients about their illness and treatment.
To understand fully how a woman copes with cancer, researchers must examine the relational contex... more To understand fully how a woman copes with cancer, researchers must examine the relational context in which a woman lives, copes, and meets the demands of a life-threatening illness. This paper presents preliminary findings of a study involving thirty-four mothers who have cancer. Survey methods involving a questionnaire were used to look at the relationship of the factors of mutuality, silencing the self schemas, and relationship-focused coping to the psychosocial adaptation to cancer. The findings indicated a significant correlation between silencing the self schemas and health care behaviors. Correlations between mutuality and quality of life approached statistical significance. Based on these findings, suggestions for social work practice with cancer patients and their families are made.
Uploads
Papers by Karen Kayser