Patricia Mumby - Academia.edu (original) (raw)

Papers by Patricia Mumby

Disease, treatment and toxicity data were retrieved from medical charts and protocol records. The... more Disease, treatment and toxicity data were retrieved from medical charts and protocol records. The most salient performance impairment was inability to eat a normal solid food diet, with 50% of patients able to eat soft foods or take liquids only. This specific functional deficit was not related to global QOL, nor to specific quality of life dimensions. Dry mouth, the most frequent and severe residual effect, was not associated with outcome diet, depression or QOL. Residual pain, seen in only 15% of patients, appeared to influence both functional and QOL parameters as well as being a marker for other troublesome symptoms. Twenty-three per cent of patients were depressed; depression was associated with past problems related to alcohol abuse. Decreased QOL and increased depressive symptomatology were related to total number and severity of residual effects. The data highlight the importance of systematic study of QOL dimensions and caution against making assumptions about patients' experience of particular disease and treatment sequelae.

Bone Marrow Transplantation, 2006

Outpatient hematopoietic stem cell transplants (HSCT) are usually performed in patients receiving... more Outpatient hematopoietic stem cell transplants (HSCT) are usually performed in patients receiving minimally mucotoxic preparative regimens; total body irradiation (TBI)-based regimens typically are excluded. To improve resource utilization and patient satisfaction, we developed a totally outpatient HSCT program for TBI regimens and compared outcomes for our first 100 such transplants to 32 performed as in-patients during the same interval, for

Nursing Science Quarterly, 2011

Recruitment and retention of persons participating in research is one of the most significant cha... more Recruitment and retention of persons participating in research is one of the most significant challenges faced by investigators. Although incentives are often used to improve recruitment and retention, evidence suggests that the relationship of the patient to study personnel may be the single, most important factor in subject accrual and continued participation. Peplau's theory of interpersonal relations provides a framework to study the nurse-patient relationship during the research process. In this paper the authors provide a brief summary of research strategies that have been used for the recruitment and retention of subjects and an overview of Peplau's theory of interpersonal relations including its use in research studies. In addition, a discussion of how this theory was used for the successful recruitment and retention of women with type 2 diabetes who participated in a clinical trial using a nurse-delivered psychoeducational intervention for depression is addressed.

Journal of Clinical Psychology in Medical Settings, 1996

The increased use of bone marrow transplantation (BMT) to treat a variety of cancers has led rese... more The increased use of bone marrow transplantation (BMT) to treat a variety of cancers has led researchers to study psychological functioning of BMT patients. The majority of studies conducted, however, has focused on adjustment after transplantation. Cancer patients' use of coping strategies before undergoing this procedure may also relate to levels of psychological distress. Our aims were (1) to provide normative coping data, controlling for situation-specific variables with a homogeneous sample, targeted stressor, and fixed time point, using the Ways of Coping Questionnaire; and (2) to identify coping strategies associated with distress before high-dose chemotherapy. Subjects were 49 patients scheduled to receive high-dose chemotherapy and an autologous bone marrow transplant. Consistent with previous coping research, we found that escape-avoidance was related to psychological distress on several measures. Item endorsement analyses of the escape-avoidance subscale suggest that patients may have used more passive than active avoidance strategies. Subsequent participation in a longitudinal study was not affected by initial levels of avoidant coping.

Journal of Clinical Oncology, 2010

The 21-gene Recurrence Score (RS) assay has been validated to quantify the risk of distant recurr... more The 21-gene Recurrence Score (RS) assay has been validated to quantify the risk of distant recurrence in tamoxifen-treated patients with lymph node-negative, estrogen receptor-positive breast cancer and predict magnitude of chemotherapy benefit. This multicenter study was designed to prospectively examine whether RS affects physician and patient adjuvant treatment selection and satisfaction.

Cancer, 1996

The FACT-H&N and PSS-HN were administered to 151 head and neck cancer patients with a range of di... more The FACT-H&N and PSS-HN were administered to 151 head and neck cancer patients with a range of disease sites, treatment status (on vs. off treatment), and treatment modalities (surgeiy, radiation, and chemotherapy).

Bone Marrow Transplantation, 2006

Biology of Blood and Marrow Transplantation, 2004

Following allogeneic HSCT, a major cause of obstruction is OB (frequency, 8-33%). Diagnosis is hi... more Following allogeneic HSCT, a major cause of obstruction is OB (frequency, 8-33%). Diagnosis is histologic, but often presumptive, based on clinical features, radiographic and PFT changes showing obstruction, hyperinflation and gas trapping. OB is associated with chronic, but not acute graft-versus-host disease (cGVHD/aGVHD). A 5% decline in percent predicted forced expiratory volume in 1 second (FEV1), FEV1/FVC (forced vital capacity) Ͻ 0.7 or 10% fractional drop from previous best PFT was suggestive of OB in previous studies. It is yet to be defined which spirometric measurement is most suggestive for the presence of OB. Forced expiratory flow rates (FEF25-75%), with Ͼ30% decline from baseline was found to be more sensitive than FEV1 in diagnosing OB following single lung transplant [Nathan, et al, 2003 J Heart and Lung Transplantation 22 : 427]. FEF25-75% has never been evaluated following allogeneic HSCT. Methods: We retrospectively reviewed PFT data on 48 adult patients undergoing HSCT from 1998-2003, who survived for at least 12 months and had pre and post-transplant PFT within 1-year of HSCT. Median age was 42 years (range, 20-57), and 54% were male. Forty-seven patients had malignant hematologic disorders. The conditioning regimen was TBI-based in 34 (73%) patients, and 13 received chemotherapy only. Marrow and peripheral blood stem cells were used in 22 and 26 patients respectively. Results: Incidence of aGVHD was 52%, (gradeI-II/III-IV: 88%/12%), 12% of patients had cGVHD (limited/extensive: 69%/13%). Ten patients (21%) had a diagnosis of OB (8-histologicaly, 2-based on signs and symptoms). Spirometric measurements considered as predictor variables included diffusion capacity for carbon monoxide (DLCO), FEV1, total lung capacity (TLC), FEF 25-75%. There was no significant association between diagnosis of OB and age, GVHD, stem cell source, preparatory regimen, TLC or DLCO. A backward elimination model building procedure for a logistic regression identified FEF25-75% as the sole significant explanatory variable. This model suggests that with a 40% decrease or more in FEF 25-75% compared to pre-transplant value, the estimated probability of the diagnosis of OB would be 50% or higher. Conclusion: A decrease in FEF 25-75% of Ն of 40%, in the absence of other non-infectious pulmonary complications, was highly suggestive in allogeneic HSCT patients for the diagnosis of OB. We plan to evaluate our findings in a prospective study.

Applied Psychophysiology and Biofeedback, 1995

The purpose of this study was to provide a thorough description of lumbar surface integrated elec... more The purpose of this study was to provide a thorough description of lumbar surface integrated electromyography (EMG) in pain-free normals during a standardized assessment protocol of static isometric and unresisted dynamic tasks. It has been proposed that in pain-free normals, symmetrical tasks that bend the trunk forward or extend the trunk backward produce symmetrical paraspinal EMG activity, and asymmetrical tasks that rotate or laterally bend the trunk produce asymmetrical paraspinal EMG activity. In addition, it has been observed that lumbar EMG assessment during static tasks has been more consistent than tasks involving dynamic activities. Twenty-eight pain-free normals were assessed during symmetrical and asymmetrical tasks in both static and dynamic activities in a counterbalanced manner. The assessment of paraspinal EMG patterns was conducted while subjects were secured in a triaxial dynamometer, which provided standardization of body position and concurrent measurement of torque, range of motion, and velocity. The results provided experimental evidence for the above-stated propositions. An implication derived from this research is that clinicians may be better served utilizing local norms when using EMG for classification purposes.

Annals of Behavioral …, 2012

BACKGROUND: Clinically significant depression is present in 25 % of individuals with type 2 diabe... more BACKGROUND: Clinically significant depression is present in 25 % of individuals with type 2 diabetes, its risk being doubled in women.
PURPOSE: To examine the effectiveness of the Study of Women's Emotions and Evaluation of a Psychoeducational (SWEEP), a group therapy for depression treatment based on cognitive behavioral therapy principles that was developed for women with type 2 diabetes was conducted.
METHODS: Women with significantly elevated depression symptoms (Center for Epidemiologic Studies Depression Scale ≥16) were randomized to SWEEP (n = 38) or usual care (UC, n = 36).
RESULTS: Multilevel modeling indicated that SWEEP was more effective than UC in reducing depression (mean difference of -15 vs. -7, p < .01), decreasing trait anxiety (mean difference of -15 vs. -5, p < .01), and improving anger expression (mean difference of -12 vs. -5, p < .05). Although SWEEP and UC had improvements in fasting glucose (mean difference of -24 vs. -1 mg/dl) and HbA1c (mean difference of -0.4 vs. -0.1 %), there were no statistically significant differences between groups.
CONCLUSIONS: SWEEP was more effective than UC for treating depressed women with type 2 diabetes. Addition of group therapy for depression meaningfully expands the armamentarium of evidence-based treatment options for women with diabetes.

Disease, treatment and toxicity data were retrieved from medical charts and protocol records. The... more Disease, treatment and toxicity data were retrieved from medical charts and protocol records. The most salient performance impairment was inability to eat a normal solid food diet, with 50% of patients able to eat soft foods or take liquids only. This specific functional deficit was not related to global QOL, nor to specific quality of life dimensions. Dry mouth, the most frequent and severe residual effect, was not associated with outcome diet, depression or QOL. Residual pain, seen in only 15% of patients, appeared to influence both functional and QOL parameters as well as being a marker for other troublesome symptoms. Twenty-three per cent of patients were depressed; depression was associated with past problems related to alcohol abuse. Decreased QOL and increased depressive symptomatology were related to total number and severity of residual effects. The data highlight the importance of systematic study of QOL dimensions and caution against making assumptions about patients' experience of particular disease and treatment sequelae.

Bone Marrow Transplantation, 2006

Outpatient hematopoietic stem cell transplants (HSCT) are usually performed in patients receiving... more Outpatient hematopoietic stem cell transplants (HSCT) are usually performed in patients receiving minimally mucotoxic preparative regimens; total body irradiation (TBI)-based regimens typically are excluded. To improve resource utilization and patient satisfaction, we developed a totally outpatient HSCT program for TBI regimens and compared outcomes for our first 100 such transplants to 32 performed as in-patients during the same interval, for

Nursing Science Quarterly, 2011

Recruitment and retention of persons participating in research is one of the most significant cha... more Recruitment and retention of persons participating in research is one of the most significant challenges faced by investigators. Although incentives are often used to improve recruitment and retention, evidence suggests that the relationship of the patient to study personnel may be the single, most important factor in subject accrual and continued participation. Peplau&amp;amp;amp;amp;amp;amp;amp;amp;#39;s theory of interpersonal relations provides a framework to study the nurse-patient relationship during the research process. In this paper the authors provide a brief summary of research strategies that have been used for the recruitment and retention of subjects and an overview of Peplau&amp;amp;amp;amp;amp;amp;amp;amp;#39;s theory of interpersonal relations including its use in research studies. In addition, a discussion of how this theory was used for the successful recruitment and retention of women with type 2 diabetes who participated in a clinical trial using a nurse-delivered psychoeducational intervention for depression is addressed.

Journal of Clinical Psychology in Medical Settings, 1996

The increased use of bone marrow transplantation (BMT) to treat a variety of cancers has led rese... more The increased use of bone marrow transplantation (BMT) to treat a variety of cancers has led researchers to study psychological functioning of BMT patients. The majority of studies conducted, however, has focused on adjustment after transplantation. Cancer patients' use of coping strategies before undergoing this procedure may also relate to levels of psychological distress. Our aims were (1) to provide normative coping data, controlling for situation-specific variables with a homogeneous sample, targeted stressor, and fixed time point, using the Ways of Coping Questionnaire; and (2) to identify coping strategies associated with distress before high-dose chemotherapy. Subjects were 49 patients scheduled to receive high-dose chemotherapy and an autologous bone marrow transplant. Consistent with previous coping research, we found that escape-avoidance was related to psychological distress on several measures. Item endorsement analyses of the escape-avoidance subscale suggest that patients may have used more passive than active avoidance strategies. Subsequent participation in a longitudinal study was not affected by initial levels of avoidant coping.

Journal of Clinical Oncology, 2010

The 21-gene Recurrence Score (RS) assay has been validated to quantify the risk of distant recurr... more The 21-gene Recurrence Score (RS) assay has been validated to quantify the risk of distant recurrence in tamoxifen-treated patients with lymph node-negative, estrogen receptor-positive breast cancer and predict magnitude of chemotherapy benefit. This multicenter study was designed to prospectively examine whether RS affects physician and patient adjuvant treatment selection and satisfaction.

Cancer, 1996

The FACT-H&N and PSS-HN were administered to 151 head and neck cancer patients with a range of di... more The FACT-H&N and PSS-HN were administered to 151 head and neck cancer patients with a range of disease sites, treatment status (on vs. off treatment), and treatment modalities (surgeiy, radiation, and chemotherapy).

Bone Marrow Transplantation, 2006

Biology of Blood and Marrow Transplantation, 2004

Following allogeneic HSCT, a major cause of obstruction is OB (frequency, 8-33%). Diagnosis is hi... more Following allogeneic HSCT, a major cause of obstruction is OB (frequency, 8-33%). Diagnosis is histologic, but often presumptive, based on clinical features, radiographic and PFT changes showing obstruction, hyperinflation and gas trapping. OB is associated with chronic, but not acute graft-versus-host disease (cGVHD/aGVHD). A 5% decline in percent predicted forced expiratory volume in 1 second (FEV1), FEV1/FVC (forced vital capacity) Ͻ 0.7 or 10% fractional drop from previous best PFT was suggestive of OB in previous studies. It is yet to be defined which spirometric measurement is most suggestive for the presence of OB. Forced expiratory flow rates (FEF25-75%), with Ͼ30% decline from baseline was found to be more sensitive than FEV1 in diagnosing OB following single lung transplant [Nathan, et al, 2003 J Heart and Lung Transplantation 22 : 427]. FEF25-75% has never been evaluated following allogeneic HSCT. Methods: We retrospectively reviewed PFT data on 48 adult patients undergoing HSCT from 1998-2003, who survived for at least 12 months and had pre and post-transplant PFT within 1-year of HSCT. Median age was 42 years (range, 20-57), and 54% were male. Forty-seven patients had malignant hematologic disorders. The conditioning regimen was TBI-based in 34 (73%) patients, and 13 received chemotherapy only. Marrow and peripheral blood stem cells were used in 22 and 26 patients respectively. Results: Incidence of aGVHD was 52%, (gradeI-II/III-IV: 88%/12%), 12% of patients had cGVHD (limited/extensive: 69%/13%). Ten patients (21%) had a diagnosis of OB (8-histologicaly, 2-based on signs and symptoms). Spirometric measurements considered as predictor variables included diffusion capacity for carbon monoxide (DLCO), FEV1, total lung capacity (TLC), FEF 25-75%. There was no significant association between diagnosis of OB and age, GVHD, stem cell source, preparatory regimen, TLC or DLCO. A backward elimination model building procedure for a logistic regression identified FEF25-75% as the sole significant explanatory variable. This model suggests that with a 40% decrease or more in FEF 25-75% compared to pre-transplant value, the estimated probability of the diagnosis of OB would be 50% or higher. Conclusion: A decrease in FEF 25-75% of Ն of 40%, in the absence of other non-infectious pulmonary complications, was highly suggestive in allogeneic HSCT patients for the diagnosis of OB. We plan to evaluate our findings in a prospective study.

Applied Psychophysiology and Biofeedback, 1995

The purpose of this study was to provide a thorough description of lumbar surface integrated elec... more The purpose of this study was to provide a thorough description of lumbar surface integrated electromyography (EMG) in pain-free normals during a standardized assessment protocol of static isometric and unresisted dynamic tasks. It has been proposed that in pain-free normals, symmetrical tasks that bend the trunk forward or extend the trunk backward produce symmetrical paraspinal EMG activity, and asymmetrical tasks that rotate or laterally bend the trunk produce asymmetrical paraspinal EMG activity. In addition, it has been observed that lumbar EMG assessment during static tasks has been more consistent than tasks involving dynamic activities. Twenty-eight pain-free normals were assessed during symmetrical and asymmetrical tasks in both static and dynamic activities in a counterbalanced manner. The assessment of paraspinal EMG patterns was conducted while subjects were secured in a triaxial dynamometer, which provided standardization of body position and concurrent measurement of torque, range of motion, and velocity. The results provided experimental evidence for the above-stated propositions. An implication derived from this research is that clinicians may be better served utilizing local norms when using EMG for classification purposes.

Annals of Behavioral …, 2012

BACKGROUND: Clinically significant depression is present in 25 % of individuals with type 2 diabe... more BACKGROUND: Clinically significant depression is present in 25 % of individuals with type 2 diabetes, its risk being doubled in women.
PURPOSE: To examine the effectiveness of the Study of Women's Emotions and Evaluation of a Psychoeducational (SWEEP), a group therapy for depression treatment based on cognitive behavioral therapy principles that was developed for women with type 2 diabetes was conducted.
METHODS: Women with significantly elevated depression symptoms (Center for Epidemiologic Studies Depression Scale ≥16) were randomized to SWEEP (n = 38) or usual care (UC, n = 36).
RESULTS: Multilevel modeling indicated that SWEEP was more effective than UC in reducing depression (mean difference of -15 vs. -7, p < .01), decreasing trait anxiety (mean difference of -15 vs. -5, p < .01), and improving anger expression (mean difference of -12 vs. -5, p < .05). Although SWEEP and UC had improvements in fasting glucose (mean difference of -24 vs. -1 mg/dl) and HbA1c (mean difference of -0.4 vs. -0.1 %), there were no statistically significant differences between groups.
CONCLUSIONS: SWEEP was more effective than UC for treating depressed women with type 2 diabetes. Addition of group therapy for depression meaningfully expands the armamentarium of evidence-based treatment options for women with diabetes.