Thesis (M.A.)--Georgia State University, 2006. / Title from title screen. Lesley Reid, committee chair; Wendy Simonds, Dawn Baunach, committee members. Electronic text (80 p.) : digital, PDF file. Description based on contents viewed June 18, 2007. Includes bibliographical references (p. 66-74).

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Experimental Medicine, Department of Medicine, Faculty of Medicine & Dentistry. Title from pdf file main screen (viewed on November 21, 2009). Includes bibliographical references.

AimsParticipant drop out is a major barrier to high-quality patient-reported outcome (PRO) data analysis in cancer research as patients with worsening health are more likely to dropout. To test the hypothesis that ovarian cancer patients with worse PROs would drop out earlier, we examined how patients differed by time of dropout on health-related quality of life (HRQOL), anxiety, depression, optimism and insomnia. MethodsThis analysis included 619 participants, stratified by time of dropout, from the Australian Ovarian Cancer Study - Quality of Life substudy, in which participants completed PRO questionnaires at three-monthly intervals for 21 months. Trends in PROs over time were examined. Pearson correlations examined the relationship between time of dropout and baseline PROs. Multiple linear regression models including age, disease stage and time since diagnosis examined relationships between baseline and final PRO scores, and final PRO scores and dropout group. ResultsParticipants who dropped out earlier had significantly worse baseline HRQOL (p<0.0001) and higher depression (p<0.0001). For all five PROs, final scores were significantly associated with baseline scores (p<0.0001). Time of dropout was significantly associated with final HRQOL (p=0.003), anxiety (p=0.05), depression (p=0.02) and optimism (p=0.02) scores. Depression, HRQOL and anxiety worsened at a faster rate overtime in dropouts than study completers. ConclusionsPoorer HRQOL and higher depression at baseline, and final HRQOL, anxiety, depression and optimism scores were predictive of time of dropout. These results highlight the importance of collecting auxiliary data to inform careful and considered handling of missing PRO data during analysis, interpretation and reporting.

No description available.

Thesis (M.S.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains xiii, 177 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 147-154).

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1999. / Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2005. / Title from document title page. Document formatted into pages; contains xvii, 327 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 311-323).

[Truncated abstract] Physical healthcare uses a suite of tools for measuring response to treatment. However, reliable systems of regular patient monitoring are rare in mental healthcare. Mental health services often measure a treatment response from pre- to post- therapy, yet measurement between those occasions is less common. This omission is problematic since arguably there is a need for an alarm system in psychotherapy (Andrews & Page, 2005). A substantial minority of patients do not experience reliable change following treatment, and a small proportion deteriorates (Hansen, Lambert, & Forman, 2002; Newnham, Harwood, & Page, 2007). Without monitoring, it is not always possible to know which patients are progressing poorly. Since the publication of Howard and colleagues' (1996) proposal that patient progress be monitored routinely during therapy and the results fed back to clinicians to direct treatment, this monitoring regime has garnered attention in the United States and Europe (Lambert, 2007; Lutz, et al., 2006). Findings in outpatient psychotherapy have demonstrated that providing real-time feedback on patient progress to clinicians and patients significantly improves clinical outcomes for those patients demonstrating a negative response to treatment (Harmon et al., 2007; Lambert et al., 2001; Lambert et al., 2002). What is not yet apparent is how these processes would generalize to inpatient and day patient (i.e. patients attending hospital for a whole day of treatment) psychiatric care. Inpatients often present with greater severity and are treated in an intensive setting. ... Deviations from this expected pattern would highlight possible differences between inpatient and outpatient care. To develop an appropriate system for monitoring patient progress, it was important to first define clinically significant recovery in inpatient psychiatric care, and provide criteria for clinicians to judge outcome in routine practice (Newnham, Harwood, & Page, 2007). Second, a quick and easy-to-administer system of progress monitoring and real-time feedback was developed to enhance treatment decision making (Newnham, Hooke, & Page, 2009). Third, the system was evaluated to determine clinical effectiveness. Using the World Health Organization’s Wellbeing Index, a program for monitoring patient progress and providing feedback to clinicians and patients was established at Western Australia's largest private psychiatric service. The sample consisted of 1308 consecutive inpatients and day patients whose primary diagnoses were predominantly depressive (67.7%) and anxiety (25.9%) disorders. Feedback to patients and clinicians was effective in reducing depressive symptoms (F (1,649) = 6.29, p<.05) for those patients at risk of poor outcome, but not effective in improving wellbeing (F (1,569) = 1.14, p>.05). The findings support the use of progress monitoring and feedback in psychiatric care to improve symptom outcomes, but raise questions about changes in wellbeing during psychotherapy. The effectiveness study was conducted as a historical cohort trial, consistent with quality improvement efforts, and replication with a randomized controlled design is warranted. Feedback of progress information appears to be an important process within psychotherapy, and further investigation of the means by which clinicians and patients use that information is necessary.

Health Studies / (D. Litt. et Phil. (Health Studies))