Psychological distress in cancer is a well-documented phenomenon, but additional information is needed about demographic and disease correlates in diverse populations with different forms of cancer. This study focused on gynecologic cancers. Using the Distress Thermometer and the Hospital Anxiety and Depression Scale, this study examined distress levels in 94 women with gynecologic cancer who were being treated as outpatients at a large urban medical center. The distress levels in this sample were lower than in comparable studies, raising questions about openness to reporting distress. Those who reported higher levels of distress were more likely to also report a mental health diagnosis or psychiatric medication. This suggests that an alternate form for distress screening may involve inquiring about mental health treatment. In this sample, younger women and those with higher educational achievement or private health insurance had higher levels of distress. Conversely, there were no relations between distress levels and disease characteristics, indicating that, for example, women with early stage disease have just as much risk of distress as those with later-stage disease.
The purpose of this study was to investigate factors that influence societal perceptions of grandparents who have become custodians of their grandchildren. Over 1200 adult volunteers evaluated a randomly assigned scenario describing a grandparent raising a grandchild, where scenarios varied in terms of grandchild gender, grandparent ethnicity, the presence/absence of grandchild problems, and the reason for the assumption of the grandparent caregiving role. Subjects rated scenarios according to the extent to which they thought the custodial grandparent was experiencing a variety of losses. Overall, perceptions of loss were greater for grandmothers whose grandchild was experiencing an emotional/ behavioral problem, and for those grandmothers whose grandchild had been abandoned or abused, or whose adult child had died, been incarcerated, or abused drugs. Due to an interaction between ethnicity and reason for role assumption, however, those findings are best interpreted in the context of the ethnicity of the grandparent. Depending on the context, respondents were less sensitive to losses suffered by Hispanic, African American, or Caucasian grandmothers. These data suggest that ethnicity of the grandparent and reason for assuming the custodial role affect the degree to which people are sensitive to the losses that custodial grandparents experience. These differences are likely to affect the extent to which others publicly acknowledge the grief of custodial grandparents. Moreover, ethnic stereotypes may interfere with an equitable allocation of social support 245 Ó 2004, Baywood Publishing Co., Inc.for, and services to, grandparent caregivers. In this light, researchers should continue to study these disparities, as they are likely to affect the adjustment of grandparents to the custodial role.
Studies of psychological morbidity and quality of life in ovarian cancer (OC) patients have largely relied on selfreport measures despite substantial research questioning the confounding effects of denial and self-deception in self-report scores. This study investigated the use of the Early Memory Index (EMI) for detection of psychological distress among OC patients. Early Memory Index outcomes of 77 OC outpatients were compared with high and low distress scores on the Center for Epidemiological Studies-Depression (CES-D) and State-Trait Anxiety Inventory Form-Y (STAI-S, STAI-T). A higher percentage of participants scored as distressed on the EMI (51%) than the CES-D (30%), STAI-S (16%), and STAI-T (21%). A sizable percentage (up to 48%) of low distress respondents on self-report measures demonstrated illusory mental health on the EMI. Results support earlier research demonstrating self-report scales' limitation detecting psychological distress and the possibility of the EMI as an alternative screening measure of psychological adjustment in OC patients. K E Y W O R D S distress screening, early memories, oncology, ovarian cancer
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