Most important change after tx effects of treatment

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Unformatted text preview: construct” " Target construct = HRQOL " Reflects adaptation to a changing health state and accommodation of illness; " Response shift may result in change to individual’s internal standards, personal values or in conceptualizations of perceived HRQOL Gamba et al. Most important change after tx? Effect(s) of treatment on: Self-image, body image Relationships with: partner, children, friends Overall advantages and disadvantages of treatment Copyright 2013 - P.C. Doyle - s omeone's point of reference may change because of illness, but if one works with this individual, they may fi nd that this point of reference stabilizes - all health conditions (except those that are acute and self-limiting) carry with them dynamic changes, which are likely to affect physical, psychological and s ocial symptoms in different ways * Not going to ask about these people, these are just examples of explorations of QOL over the last 10 years that push on the envelope of the traiditonal QOL instruments * List et al (1990) Hoskins (1995) Assessed function in H & N Ca Information on “adjustment” ! Understandability of speech ! Normalcy of diet eating, chewing, swallowing ! Eating in public - until this point, questions were never asked about these topics with head and neck cancer patients Longitudinal assessment of: ! Marital support ! Support from others women will seek out help at a much higher level than men will ! Role function ! Satisfaction with health care Copyright 2013 - P.C. Doyle Copyright 2013 - P.C. Doyle Kurtz et al. (1995) Zacharias et al. (1994) Assessed long-term cancer survivors: Assessment of a “Coping Scale” ! Somatic concerns (pain and physical) ! Health habits ! Social/emotional support giving ! Philosophical/spiritual views Copyright 2013 - P.C. Doyle ! Cognitive restructuring ! Emotional expression ! Wish-fulfilling fantasy ! Self-blame ! Information seeking behavior ! Minimizing “threat” Copyright 2013 - P.C. Doyle 3 What type of “issues” are explored? They are personal response/ experience issues or those that influence social indicators! Can the following be addressed via a written, forced-choice measure? Some comments !  “Because of the background noise in public, I no longer wish to talk to others.” (Isolation) !  “You bet there are times when I’m depressed and I do believe it’s because I’m aware that it is from my own doing.” (Guilt) !  “I know others see me as different, but it doesn’t make me any less capable of living and being productive.” (Social penalty) !  “Several times I’ve almost said fuck it all, it’s no longer worth it.” (despair, distress, depression) Copyright 2013 - P.C. Doyle Copyright 2013 - P.C. Doyle more comments and a few more !  “I came out of surgery f...
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