Psychology Commons^™

First-Year Trends In Self-Reported General Health Predict Survival In Patients With Head And Neck Cancer, Mark Jameson, Lucy Karnell, Alan Christensen

Alan J. Christensen

Objective To demonstrate that first-year trends in a self-reported subjective general health assessment tool can provide prognostic information and help predict long-term survival in patients with head and neck cancer.

Design Prospective observational cohort study.

Setting Tertiary care center.

Patients Four hundred three patients with head and neck cancer who were enrolled in a longitudinal outcomes project between January 1, 1995, and December 31, 2005.

Intervention Self-reported general physical health assessments were collected using the Medical Outcomes Study 36-Item Short-Form Health Survey at diagnosis (pretreatment) and at 3, 6, 9, and 12 months after diagnosis.

Main Outcome Measures Actuarial 5-year …

Patient Adherence To Medical Regimens: Toward A Contextual Understanding, Alan Christensen

Alan J. Christensen

No abstract provided.

Patient-Reported Factors Associated With Discontinuing Employment Following Head And Neck Cancer Treatment, Andrea Buckwalter, Lucy Karnell, Russell Smith, Alan Christensen, Gerry Funk

Alan J. Christensen

Objective To evaluate patients' reported reasons for discontinuing employment following treatment for head and neck cancer (HNC). Discontinuing employment is a serious problem for patients with HNC and has an impact on many aspects of their lives.

Design Prospective, observational outcomes study.

Setting Tertiary care institution.

Patients A total of 666 patients with carcinomas of the head and neck who were treated from January 1, 1998, to October 31, 2004.

Interventions Patients provided information about the status of their employment at the time of diagnosis and then at 3, 6, 9, and 12 months after diagnosis. Patients who discontinued employment …

Health-Related Quality Of Life Profiles Based On Survivorship Status For Head And Neck Cancer Patients, David Goldstein, Lucy Karnell, Alan Christensen, Gerry Funk

Alan J. Christensen

Background. As the methodologies for evaluating health-related quality of life (HRQOL) in head and neck cancer patients have matured over the past 10 years, there has been an increasing focus on reporting longitudinal data. These studies have primarily focused on long-term survivors. This study addresses the HRQOL of both long-term and short-term survivors.

Methods. This is a prospective, longitudinal study of 479 head and neck cancer patients followed for at least 3 years after diagnosis. Analysis of longitudinally collected HRQOL scores was based on survivorship status.

Results. The HRQOL for 3 survivorship groups: short-term (died <1>year), intermediate-term (died 1-3 years), …

Influence Of Social Support On Health-Related Quality Of Life Outcomes In Head And Neck Cancer, Lucy Karnell, Alan Christensen, Eben Rosenthal, J Magnuson, Gerry Funk

Alan J. Christensen

Background. Evidence that social support influences health-related quality of life (HRQOL) in oncologic patients could be particularly important for head and neck cancer because this disease can affect speech, eating, and facial aesthetics.

Methods. Multiple regression analyses were used in this prospective, observational study to determine the association between 394 patients' ratings of perceived post-treatment social support and HRQOL outcomes while controlling for possible confounding variables.

Results. Higher social support scores were significantly associated with higher scores in speech (p = .007), aesthetics (p = .015), social disruption (p = .045), and general mental health (p = .016) and with …

A Longitudinal Examination Of Social Support, Agreeableness And Depressive Symptoms In Chronic Kidney Disease, Karin Hoth, Alan Christensen, Shawna Ehlers, Katherine Raichle, William Lawton

Alan J. Christensen

Research examining the role of social support in patient adjustment to chronic illness has been inconsistent suggesting that patient individual differences play a moderating role. This study examined the hypothesis that the relationship between social support and depressive symptoms would differ as a function of individual differences in trait Agreeableness. Fifty-nine patients with chronic kidney disease were assessed using the Social Provisions Scale, Beck Depression Inventory and NEO-Five-Factor Inventory and were followed-up a year and a half later. After controlling for baseline depressive symptoms and clinical characteristics, regression analyses revealed a significant interaction between social support and Agreeableness predicting change …

A Biobehavioral Research Program In Chronic Kidney Disease, Alan Christensen

Alan J. Christensen

No abstract provided.

Patient Adherence To Medical Regimens: Levels Of Understanding And Intervention, Alan Christensen

Alan J. Christensen

No abstract provided.

The Role Of Depression In Withdrawal From Renal Dialysis, Elizabeth Mcdade-Montez, Alan Christensen, Jaime Cvengros, William Lawton

Alan J. Christensen

Among end-stage renal disease (ESRD) patients on hemodialysis, death from withdrawal from life-sustaining dialysis is increasingly common. The present study's objective was to examine depression as a potential risk factor for hemodialysis withdrawal. Two hundred forty ESRD hemodialysis (133 male and 107 female) patients were followed for an average of 4 years after depression symptom assessment. Of these, 18% withdrew from dialysis. Using multivariate survival analysis and after controlling for the effects of age (p = .001) and clinical variables, the authors found that level of depression symptoms was a unique and significant predictive risk factor for the subsequent decision …

A Randomized Trial To Assess The Impact Of Direct Reporting Of Dxa Scan Results To Patients On Quality Of Osteoporosis Care, Peter Cram, Janet Schlechte, Alan Christensen

Alan J. Christensen

Consecutive patients identified as having osteoporosis on screening dual-energy X-ray absorptiometry (DXA) scans were randomized to: (1) a patient activation intervention consisting of mailing patients their DXA scan results supplemented by a call from a nurse educator or (2) usual care. Three months after the DXA scan, patients were contacted to assess: (1) use of antiresorptive therapy, (2) osteoporosis specific knowledge, and (3) satisfaction with their osteoporosis-related care. A total of 1,035 consecutive patients were screened to identify 422 eligible patients. Of these, 56 patients met inclusion criteria and were subsequently randomized. At follow-up, use of antiresorptive agents was numerically …

Health Locus Of Control And Depression In Chronic Kidney Disease: A Dynamic Perspective, Jamie Cvengros, Alan Christensen, William Lawton

Alan J. Christensen

Participants in the present study were 207 patients with chronic kidney disease (CKD) who completed internal HLOC and depression measures at baseline and at an approximately 16-month follow-up period. Regression results indicated that after controlling for baseline level of depression, baseline internal HLOC was not a significant predictor of depression at follow-up. However, increases in internal HLOC over the 16-month follow-up were predictive of depression at follow-up. Furthermore, this relationship was qualified by an interaction between change in internal HLOC and disease progression. These results suggest that changes in internal HLOC over time may be a particularly important determinant of …

Patient Adherence To Medical Regimens: The Action Is In The Interaction, Alan Christensen

Alan J. Christensen

No abstract provided.

Getting Your Work Into Print” (Professional Development Seminar, Alan Christensen

Alan J. Christensen

No abstract provided.

“Patient Adherence To Medical Regimens: Levels Of Understanding And Intervention, Alan Christensen

Alan J. Christensen

No abstract provided.

Patient Adherence To Medical Regimens: Levels Of Understanding And Intervention, Alan Christensen

Alan J. Christensen

No abstract provided.

Clinical Significance Of Health Status Assessment Measures In Head And Neck Cancer, Gerry Funk, Lucy Karnell, Russell Smith, Alan Christensen

Alan J. Christensen

Objectives To determine the magnitude of clinically significant differences in domain scores for a quality-of-life questionnaire specific to head and neck cancer; and to demonstrate a clinically relevant method of presenting head and neck cancer–specific quality-of-life data using cutoff scores and clinical anchors.

Design Anchor-based and distribution-based techniques for determining clinically significant differences in health-related quality-of-life scores were used.

Setting University-based tertiary care hospital.

Patients A total of 421 patients with head and neck cancer enrolled in a longitudinal outcomes project.

Main Outcome Measures The Head and Neck Cancer Inventory; clinical anchor health status in the domains of speech, eating, …

The Role Of Perceived Control And Preference For Control In Adherence To A Chronic Medical Regimen, Jamie Cvengros, Alan Christensen, William Lawton

Alan J. Christensen

Background: Poor patient adherence is a widespread problem among patients undergoing hemodialysisfor end-stage renal disease.

Purpose: The goal of this study was to examine the joint role of perceived restriction of control and individual differences in preference for control in predicting adherence to the hemodialysis regimen.

Methods: Participants were 49 patients recruited from five hemodialysis centers affiliated with the University of Iowa Hospitals and Clinics. Preference for control in the health care context was assessed using the Preference for Information and Preference for Behavioral Involvement subscales of the Krantz Health Opinion Survey, and perceived control was assessed using six items …

Technological And Medical Advances: Implications For Health Psychology, Patrice Saab, Judith Mccalla, Helen Coons, Alan Christensen, Robert Kaplan, Suzanne Johnson, Mark Ackerman, Edward Stepanski, David Krantz, Barbara Melamed

Alan J. Christensen

Behavioral telehealth, health informatics, organ and tissue transplantation, and genetics are among the areas that have been affected by advances in technology and medicine. These areas illustrate the opportunities and the challenges that new developments can pose to health psychologists. Each area is discussed with respect to implications for practice, research, public policy, and education and training: recommendations are provided. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Patient Adherence To Medical Treatment Regimens : Challenges For Behavioral Science And Biomedicine, Alan Christensen

Alan J. Christensen

No abstract provided.

Behavioral And Medical Treatment Of Chronic Polydipsia In A Patient With Schizophrenia And Diabetes Insipidus, Erin Costanzo, Lisa Antes, Alan Christensen

Alan J. Christensen

This case report describes a novel outpatient behavioral treatment intervention for chronic polydipsia. The program was used in an effort to reduce excessive fluid intake in a woman with chronic paranoid-type schizophrenia who also had a diagnosis of diabetes insipidus.

Encyclopedia Of Health Psychology, Alan Christensen, Rene Martin, Joshua Smith

Alan J. Christensen

No abstract provided.

"Irrational Health Appraisals: An Alternative View Of Cognition And Health, Alan Christensen

Alan J. Christensen

No abstract provided.

Comprehensive Head And Neck Oncology Health Status Assessment, Gerry Funk, Lucy Karnell, Alan Christensen, Patricia Moran, Joan Ricks

Alan J. Christensen

Background. This article presents the validation of the Head and Neck Cancer Inventory (HNCI), a health status assessment instrument with a small number of multiple-item domains that captures patients' ratings of functional status and attitude about that function.

Methods. The HNCI was administered to patients with upper aerodigestive tract carcinoma. An initial, cross-sectional study assessed feasibility and reliability. A subsequent, longitudinal study's factor analysis identified ineffective items and confirmed domain cohesiveness. Construct and criterion-related validity and sensitivity to detect change across time were evaluated.

Results. The HNCI was highly reliable. Criterion-related validity was demonstrated through comparisons with other HNC-specific instruments. …

Predicting Health-Related Quality Of Life In Renal Transplantation, Alan Christensen

Alan J. Christensen

No abstract provided.

Patient Treatment Adherence Research In Chronic Disease: The Action Is In The Interaction, Alan Christensen

Alan J. Christensen

No abstract provided.

Effect Of Family Environment And Donor Source On Patient Equality Of Life Following Renal Transplantation, Alan Christensen, Katherine Raichle, Shawna Ehlers, Andrew Bertolatus

Alan J. Christensen

The authors examined the degree to which the supportiveness of a patient's family environment predicts change in quality of life following renal transplantation. The sample consisted of 95 patients receiving renal grafts from either a living donor or a cadaveric donor. Patients were initially assessed prior to transplantation with follow-up assessment occurring an average of 5.5 months after transplantation. Among patients receiving a living-donor kidney, those reporting a more supportive family environment exhibited reduced depression, improved mobility, and improved social functioning. However, those living-donor recipients reporting less family support exhibited increased depression and diminished mobility and social functioning after transplantation. …

Patient Personality And Mortality: A 4-Year Prospective Examination Of Chronic Renal Insufficiency, Alan Christensen, Shawna Ehlers, John Wiebe, Patricia Moran, Katherine Raichle, Karin Ferneyhough, William Lawton

Alan J. Christensen

The present study examined the role of personality as a predictor of mortality among patients with chronic renal insufficiency. A prospective evaluation of the influence of personality on patient survival was conducted over an average 49-month period. Cox regression was used to evaluate the effects of 5 dimensions of personality in a sample of 174 patients (100 male and 74 female). At follow-up, 49 patients had died. Significant demographic and clinical predictors of survival included age, diabetic status, and hemoglobin level. After these predictors were controlled for, 2 personality traits, conscientiousness and neuroticism, predicted patient mortality. Patients with high neuroticism …

Patient Adherence With Medical Treatment Regimens: An Interactive Approach, Alan Christensen, Jamie Johnson

Alan J. Christensen

Inadequate patient adherence to treatment regimens is a ubiquitous problem in health care and carries a profound personal, societal, and economic cost. This article illustrates a general theoretical framework we believe to be useful for the interpretation, conception, and design of adherence research. The core tenet of this framework is that factors that influence adherence can be better understood by considering the interactive effects of patients' characteristics, type of adherence intervention, and characteristics of the illness and medical treatment context. This framework represents an extension and application of previous theory and research from personality, social, and clinical psychology concerning the …

Psychological Factors In End-Stage Renal Disease: An Emerging Context For Behavioral Medicine Research, Alan Christensen, Shawna Ehlers

Alan J. Christensen

End-stage renal disease (ESRD) is a chronic, life-threatening condition afflicting over 300,000 Americans. Patient nonadherence and psychological distress are highly prevalent among ESRD patients, and both have been found to contribute to greater morbidity and earlier mortality in this population. A range of factors have been examined as potential determinants of adherence and adjustment. Evidence suggests that adherence and adjustment are maximized when a patient's preferred style of coping is consistent with the contextual features or demands of the renal intervention the patient is undergoing. Challenges for future clinical research include refining methodologies for the assessment of depression and adherence, …

An Interactive Framework For Patient Adherence Research, Alan Christensen

Alan J. Christensen

No abstract provided.