Treatment with controlled exercise is a safe program that appears to improve PCS symptoms when compared with a no-treatment baseline. A randomized controlled study is warranted.

Ovarian cancer is a life-threatening diagnosis which poses multiple challenges. The purpose of this study is to describe the quality of life (QOL) concerns and survivorship sequelae of long-term (>5 yr) early-stage ovarian cancer survivors accrued through the clinical cooperative Gynecologic Oncology Group. Forty-nine ovarian cancer survivors with a mean age at diagnosis of 55.9 yr (range 30-76) completed a telephone interview assessing QOL, psychosocial status, sexual functioning and late-effects of treatment. Results indicate that this disease-free early-stage sample enjoys a good QOL, with physical, emotional, and social well-being comparable to other survivors and same-aged noncancer cohorts. However, 20% of survivors indicated the presence of long-term treatment side effects, with a subset reporting problems related to abdominal and gynecologic symptoms, and neurotoxicity. Spiritual well-being was significantly positively associated with personal growth and mental health, and negatively associated with a declining health status. Lingering psychological survivorship sequelae included fear of follow-up diagnostic tests and fear of recurrence. Forty-three percent of respondents expressed that they would likely participate in a counseling program today to discuss psychosocial issues raised by having had ovarian cancer, and 56% stated that they would have attended a support program during the initial treatment if it had been offered. This information provides some insight into the complex survivorship relationships between quality of life, long-term physical and sexual sequelae, and factors of resilience and growth which appear to promote a sense of well-being as a result of the cancer experience.

ELDVs are commonly experienced phenomena during the dying process, characterized by a consistent sense of realism and marked emotional significance. These dreams/visions may be a profound source of potential meaning and comfort for the dying, and therefore warrant clinical attention and further research.

Abstract-The Department of Veterans Affairs (VA) uses the Neurobehavioral Symptom Inventory (NSI) to measure postconcussive symptoms in its comprehensive traumatic brain injury (TBI) evaluation. This study examined the NSI's item properties, internal consistency, and external validity. Data were obtained from a federally funded study of the experiences of combat veterans. Participants included 500 Operations Iraqi and Enduring Freedom veterans, 219 of whom sustained at least one TBI. Data were collected at five VA medical centers and one VA outpatient clinic across upstate New York. Measures included neuropsychological interview, NSI, Beck Anxiety Inventory, Beck Depression Inventory-II, and Posttraumatic Stress Disorder Checklist-Military Version. The NSI demonstrated high internal consistency (total alpha = 0.95; subscale alpha = 0.88 to 0.92). Subscale totals based on Caplan et al.'s factor analysis correlated highly with the NSI total score (r = 0.88 to 0.93). NSI scores differentiated veterans with TBI history from those without but were strongly influenced by variance associated with probable posttraumatic stress disorder, depression, and generalized anxiety. Results suggest that the NSI is a reliable and valid measure of postconcussive symptoms. Scale validity is evident in the differentiation of TBI and non-TBI classifications. The scale domain is not limited to TBI, however, and extends to detection of probable effects of additional affective disorders prevalent in the veteran population.

The goal of this study was to determine the needs of ALS family caregivers. Utilizing a qualitative and quantitative mixed methodology known as Concept Mapping (CM), individual interviews with family caregivers of ALS patients (n =19) identified 109 needs. The needs were sorted and rated by 12 of the family caregivers, then analyzed using multidimensional scaling and cluster analysis. In addition, the caregivers completed the SF-8 QoL measure. The analysis resulted in a four-cluster map, representing the trajectory of the ALS family caregivers' needs: Stage 1: Early Coping and Adjustment; Stage 2: Maintenance; Stage 3: Transition to End Stage; and Stage 4: Coping with Change and Loss. The SF-8 results indicated that caregivers who resided with their ALS family member have poorer mental and physical health than family caregivers who did not have primary residence with the ALS patient. In conclusion, a model of needs for ALS family caregivers was established. Future studies addressing these needs may improve QoL of ALS family caregivers as well as ALS patients.

The VATBIST appears to be a reliable and valid instrument. The presence of significant posttraumatic stress disorder symptoms, however, reduces the accuracy of the measure and highlights the need for careful clinical follow-up of persons who screen positive.

MP reduced symptoms of fatigue and depression when compared with placebo. The effect of MP on fatigue was dose-dependent and sustained over the duration of the study.

A transactional approach was used to examine stress and coping among 59 oncology nurses. Nine work stress clusters were identified: Physician-Related Stress, Organizational Factors, Observing Suffering, Ethical Concerns, Death and Dying, Carryover Stress, Negative Self-Thoughts, Inadequate Resources, and Coworker Stress, with the first 3 rated as most frequent and most intense. Ten coping clusters were also identified: Coworker Support, Positive Reappraisal, Developing a Growth Perspective, Positive Involvement in Treatment, Affective Regulation, Balancing Work Stress, Negative Coping, Apathy, Withdrawal, and Catharsis, with the first 3 rated as most frequently used and most effective. The relationships among the clusters, as well as the theoretical and clinical implications of these results, were discussed.