CANCER-RELATED Fatigue. Nelson Byrne, Ph.D., C.Psych. Krista McGrath, MRT(T), HBSc.
|
|
- Gavin Earl Walker
- 5 years ago
- Views:
Transcription
1 CANCER-RELATED Fatigue Nelson Byrne, Ph.D., C.Psych. Krista McGrath, MRT(T), HBSc.
2 Faculty/Presenter Disclosure Faculty: Nelson Byrne, Ph.D., C.Psych. and Krista McGrath, MRT(T), HBSc. with the Mississauga Halton/Central West Regional Cancer Program: Primary Care Oncology Day Relationship with Commercial Interests: No affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization.
3 Agenda Definition Prevalence Etiology Clinical presentation Pathophysiology Screening Assessment Interventions and management
4 Cancer-Related Fatigue a distressing persistent, subjective sense of physical, emotional and/or cognitive tiredness related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning (NCCN, 2010).
5 Case Study Mrs. L. Mrs. L. is a 52-year-old woman diagnosed with T2N0 triple negative left-sided breast cancer treated with mastectomy and dose dense chemotherapy. She completed chemotherapy about a year ago. Mrs. L. and her husband emigrated from China in She lives with her husband and two young adult children. She recently returned to work full-time in an accounting office. Her return to work was gradual over a period of 8 weeks. At work she struggles with concentration and memory. She complains of some non-specific joint aches and pains, especially since completing chemotherapy. She describes feeling completely exhausted at the end of the work day and feels guilty about not being able to care for her family s needs as well as she would like. When asked to describe her current energy level relative to where it was prior to cancer, she indicates it is at about 50%. The couple reports that fatigue impacts their physical intimacy. Activities that Mrs. L. used to enjoy doing are now limited.
6 Case Study Mrs. L. (continued) Mrs. L. reports that she interprets every physical symptom she now experiences as a sign of cancer recurrence. She endorses physical symptoms of anxiety such as racing heart, shortness of breath, and muscle tension. She also describes a number of frequent worries, such as the success of her children, her mother s health, conflicts between family members, etc. Mrs. L. reports that when she goes to bed at night, these worries occupy much of her thinking, and it can take her several hours to fall asleep. On a good night, she reports getting about 4-5 hours of sleep, with interruptions. Even prior to her cancer diagnosis, Mrs. L. struggled with sleep. Mrs. L. described a previous episode of depression following the sudden death of a close relative about 15 years ago for which she was prescribed Paxil for a 10-month period.
7 Cancer-Related Fatigue Most common symptom experienced by cancer patients Has the greatest impact on everyday life Related to cancer or its treatment May occur at any time throughout treatment and continue after completion of treatment May not get better with sleep or rest
8 Prevalence 60-90% of cancer patients will experience cancer related fatigue (Cella et al, 2010) fatigue in the normal population is reported at ~6% Among cancer outpatients, 58% report that fatigue affects them somewhat or very much (Stone et al, 2000) comparable figures for pain and nausea/vomiting are 22% and 18%, respectively Varies by type and stage of cancer Cancer related fatigue may persist for years (up to 30% of cancer survivors report persistent fatigue for years after antineoplastic therapy (Portenoy, 1999))
9 Anemia Reduces the amount of oxygen available to cells resulting in fatigue Most common cause of reversible fatigue Occurs in about ½ of all cancer patients undergoing treatment Caused by several factors destruction of red blood cells from treatments iron deficiency vitamin B12 deficiency Treatment of anemia will depend on the cause
10 Chemotherapy Your patients fatigue may get worse over time while on chemotherapy They may feel more fatigued shortly after their chemotherapy treatment and before their next treatment begins they will likely begin to feel less fatigued1 Level of Fatigue One Cycle Chemo Cycles
11 Radiation Therapy Your patients fatigue will depend on many different factors related to their radiation treatments e.g., radiation dose, area being treated, and whether or not they are having chemo and radiation therapy in combination Their fatigue may get worse over the course of their treatment and will usually peak after the treatments are completed Their fatigue may last for several months after finishing radiation End of treatment Level of Fatigue Time
12 Clinical Presentation Tiredness/exhaustion, disproportionate to recent activity Impairment in important areas of life (e.g. ADL s, work, social life) Diminished concentration or attention Significant distress or negative mood related to feeling fatigued Sleep disturbance Decreased motivation or interest to engage in usual activities/disturbance in quality of life Sleep perceived as non-restorative/unrefreshing
13 (Hypothetical) Pathophysiology Physiological factors Increased production of cytokines Dysregulation of cortisol by HPA axis Serotonin dysregulation caused by proinflammatory cytokines Psychosocial factors Depression Stress and anxiety Insomnia Circadian rhythm disruption
14 Screening Routine screening should happen from diagnosis forward Screen with a valid and reliable tool that includes reportable scores (dimensions) that are clinically meaningful and have established cut-offs e.g., Screening for Distress Tool, which includes Edmonton Symptom Assessment System (ESAS) and Canadian Problem Checklist (CPC)
15 Assessment Rule out other causes not disease related Shared responsibility History of fatigue Contributing risk factors Physical exam Review of symptoms Self-assessment of contributing causes
16 Interventions and Management OF CANCER-RELATED FATIGUE
17 Interventions and Management Interventions for all patients, all ESAS scores Interventions for moderate and severe fatigue: Address treatable contributing factors Non-pharmacologic interventions Pharmacologic interventions
18 Interventions for all patients Education and counseling Differences between normal and cancer related fatigue Causes and consequences of fatigue Treatment related patterns of fatigue Avoid inactivity during and post treatment Use energy wisely planning, prioritizing, pacing, position
19 Interventions for all patients Education and counseling Sleep hygiene Distraction techniques Use of a fatigue journal to track severity and self-management strategies Signs of worsening fatigue to report to HCP
20 Consider contributing factors for moderate or severe fatigue Treatment complications e.g., anemia, infection, fever Medication side-effects e.g., opiates, antiemetics, antihistamines, antidepressants, etc. Endocrine, cardiac, pulmonary factors e.g., hypothyroidism, adrenal insufficiency
21 Consider contributing factors for moderate or severe fatigue Nutritional deficiencies Fluid and electrolyte imbalances Emotional distress Sleep disturbance Other ESAS-rated symptoms: pain, nausea, depression
22 Non-pharmacologic interventions for moderate or severe fatigue Moderate physical activity during and after treatment 30 mins per day, 5 days per week Unless contraindicated or previously sedentary Psychosocial interventions Psycho-educational programs (group or individual) Anticipatory guidance re: fatigue patterns Coping skills training Self-management and problem solving to manage fatigue Cognitive Behavioural Therapy from trained therapist Supportive expressive therapies
23 Non-pharmacologic interventions for moderate or severe fatigue Nutritional consultation Optimize sleep quality (CBTi) Attention restoring therapy Stress reduction strategies Progressive muscle relaxation, yoga, mindfulness, guided imagery, massage Acupuncture may be effective
24 Pharmacologic interventions for moderate or severe fatigue Methylphenidate Dexamethasone, prednisone Modafinil Amantadine
25 Pharmacologic interventions for moderate or severe fatigue Pharmacologic interventions should be used cautiously and should not be used until treatment and disease-specific morbidities have been characterized and ruled out Optimal dosing and schedules have not been established for use of pharmacologic interventions in cancer patients
26 Case Study Mrs. L. Mrs. L. is a 52-year-old woman diagnosed with T2N0 triple negative left-sided breast cancer treated with mastectomy and dose dense chemotherapy. She completed chemotherapy about a year ago. Mrs. L. and her husband emigrated from China in She lives with her husband and two young adult children. She recently returned to work full-time in an accounting office. Her return to work was gradual over a period of 8 weeks. At work she struggles with concentration and memory. She complains of some non-specific joint aches and pains, especially since completing chemotherapy. She describes feeling completely exhausted at the end of the work day and feels guilty about not being able to care for her family s needs as well as she would like. When asked to describe her current energy level relative to where it was prior to cancer, she indicates it is at about 50%. The couple reports that fatigue impacts their physical intimacy. Activities that Mrs. L. used to enjoy doing are now limited.
27 Case Study Mrs. L. (continued) Mrs. L. reports that she interprets every physical symptom she now experiences as a sign of cancer recurrence. She endorses physical symptoms of anxiety such as racing heart, shortness of breath, and muscle tension. She also describes a number of frequent worries, such as the success of her children, her mother s health, conflicts between family members, etc. Mrs. L. reports that when she goes to bed at night, these worries occupy much of her thinking, and it can take her several hours to fall asleep. On a good night, she reports getting about 4-5 hours of sleep, with interruptions. Even prior to her cancer diagnosis, Mrs. L. struggled with sleep. Mrs. L. described a previous episode of depression following the sudden death of a close relative about 15 years ago for which she was prescribed Paxil for a 10-month period.
28 QUESTIONS? 29
Why am I so Tired? Cancer Related Fatigue. Rose Bell, PhD, ARNP, AOCNP Northwest Medical Specialties
Why am I so Tired? Cancer Related Fatigue Rose Bell, PhD, ARNP, AOCNP Northwest Medical Specialties Cancer Related Fatigue (CRF) Significantly different in quality and severity Unrelieved by sleep or rest
More information8/29/2013. Discuss Relation of Fatigue to Sleep Disturbance. Assessing and Treating Factors Contributing to Fatigue and Sleep Disturbance
Timothy Pearman, Ph.D. Director, Supportive Oncology Robert H. Lurie Comprehensive Cancer Center Associate Professor of Medical Social Sciences and Psychiatry Northwestern University Feinberg School of
More informationSunil Nagpal MD Director, Thoracic Oncology West Michigan Cancer Center
Sunil Nagpal MD Director, Thoracic Oncology West Michigan Cancer Center Disclosures No disclosures Definition of Cancer Related Fatigue Cancer related fatigue is a distressing, persistent, subjective sense
More informationFATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT. Fausto Roila Medical Oncology Division, Terni, Italy
FATIGUE: PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT Fausto Roila Medical Oncology Division, Terni, Italy CONFLICT OF INTERESTS NO CONFLICT FATIGUE: DEFINITION (ASCO, NCCN) Cancer-related fatigue
More informationSymptom Control in Cancer Rehabilitation. Ying Guo, MD Department of Palliative, Rehabilitation and Integrative Medicine UT MD Anderson Cancer Center
Symptom Control in Cancer Rehabilitation Ying Guo, MD Department of Palliative, Rehabilitation and Integrative Medicine UT MD Anderson Cancer Center Cancer Patients Symptoms Pain- 90% of patients with
More informationManaging Fatigue in Bone Marrow Failure Diseases
Managing Fatigue in Bone Marrow Failure Diseases Lora Thompson, Ph.D. Clinical Psychologist Psychosocial and Palliative Care Program Moffitt Cancer Center Definition of Fatigue a distressing, persistent,
More informationFatigue and Chronic Fatigue Syndrome
Fatigue and Chronic Fatigue Syndrome Introduction Nearly everyone struggles with being overtired or overworked from time to time. Temporary fatigue usually has a specific cause. It is easily treated. Chronic
More informationSleep, Stress, and Fatigue
Sleep, Stress, and Fatigue Central Washington University E.A.S.E. Cancer Foundation Tim Burnham Ph.D. Interrelated Stress Sleep disturbance Fatigue Stress Stress is YOUR response to a situation Stressor:
More informationLiving Well with Bone Marrow Failure Diseases
Living Well with Bone Marrow Failure Diseases ISABEL SCHUERMEYER, MD DIRECTOR OF PSYCHO-ONCOLOGY CLEVELAND CLINIC JUNE 22, 2013 Overview What do we know about symptoms & quality of life for bone marrow
More informationFatigue Management in Cancer Care
Fatigue Management in Cancer Care Overview 1. What is Cancer-Related Fatigue? Causes & symptoms 2. Negative cycles that fuel CRF 3. What are the consequences of CRF 4. Intervention & rehabilitation 5.
More informationImproving Your Sleep Course. Session 1 Understanding Sleep and Assessing Your Difficulties
Improving Your Sleep Course Session 1 Understanding Sleep and Assessing Your Difficulties Course Information Session Details Sessions Session 1 Session 2 Session 3 Session 4 Optional Review Session 5 Session
More information10/8/2014. Quality of Life: On score of 0 (poor) 10 (excellent): MDS average = 5.1. Normal average = 7.7
What do we know about symptoms & quality of life for bone marrow failure disease patients? Isabel Schuermeyer, MD Director of Psycho-Oncology Cleveland Clinic AA/MDS International Foundation 2014 regional
More informationSue Johnson May Fatigue in Palliative Care
Sue Johnson May 2017 Fatigue in Palliative Care Why fatigue? Palliative care patients identify fatigue as a significant symptom. Fatigue is one of the most complex symptoms experienced by cancer patients
More informationINSOMNIAS. Stephan Eisenschenk, MD Department of Neurology
INSOMNIAS INSOMNIAS General criteria for insomnia A. Repeated difficulty with sleep initiation, duration, consolidation or quality. B. Adequate sleep opportunity, persistent sleep difficulty and associated
More informationa persistent symptom, a subjective feeling of physical, emotional or cognitive tiredness or exhaustion related to cancer or its treatment that is not
a persistent symptom, a subjective feeling of physical, emotional or cognitive tiredness or exhaustion related to cancer or its treatment that is not proportional to the recently performed activity, and
More informationOncology Nursing Society Registry in Collaboration with CE City 2015 Performance Measure Specifications
1 ONSQIR 1 Non-PRQS Measure Oncology Nursing Society Registry in Collaboration with CE City 2015 Performance Measure Specifications Performance Measure Name: Symptom Assessment 1-o1a Symptom Assessment
More informationObjectives. Combating Fatigue Bone Marrow Failure Disorders
Combating Fatigue Bone Marrow Failure Disorders Tracy Krimmel, RN, AOCN, APRN-BC Hematologic Malignancies Nurse Practitioner Objectives Understand definition and impact of fatigue on bone marrow failure
More informationDepression. How to Manage Your
How to Manage Your Depression The recommendations in this guide are based on published evidence and expert consensus. The information in this guide was adapted from the following patient tools: Managing
More informationThe World Health Organization has developed and has widely accepted an algorithm for treatment of cancer pain. This is described as the three-step lad
Hello. My name is Cynthia Abarado. I m an Advanced Practice Nurse at the Department of Genitourinary Medical Oncology at The University of Texas MD Anderson Cancer Center. I am going to present to you
More informationCancer and Cognitive Functioning: Strategies for Improvement
Cancer and Cognitive Functioning: Strategies for Improvement Myron Goldberg, Ph.D., ABPP-CN Clinical Neuropsychologist Director, Neuro-Rehabilitation Program Department of Rehabilitation Medicine University
More informationP A N A N X I E T Y C
P A N A N X I E T Y C The terms panic attack and anxiety attack are used interchangeably, but they are not the same. Key characteristics distinguish one from the other, though they have several symptoms
More informationCBT in the Treatment of Persistent Insomnia in Patients with Cancer
CBT in the Treatment of Persistent Insomnia in Patients with Cancer Colin A Espie University of Glasgow Sleep Centre Sackler Institute of Psychobiological Research University of Glasgow Scotland UK Outline
More informationDEPRESSION. There are a couple of kinds, or forms. The most common are major depression and dysthymic disorder.
DEPRESSION OBJECTIVES: At the end of this class, you will be able to: 1.list and describe several kinds of depression, 2.discuss the signs of depression, and 3.relate the treatment of depression. INTRODUCTION
More informationFatigue and Quality of Life. Overview What do we know about symptoms & quality of life for bone marrow failure disease patients?
Breaking Point: Learning How to Relax, Relate, and Release Isabel Schuermeyer, MD Director of Psycho-Oncology Cleveland Clinic AA/MDS International Foundation 2014 regional conference September 20, 2014
More informationPatient Clinic Leaflet. chronic fatigue syndrome (CFS) myalgic encephalomyelitis or myalgic encephalopathy (ME)
Patient Clinic Leaflet Basic information on your illness and the treatments we can offer you for chronic fatigue syndrome (CFS) also known as myalgic encephalomyelitis or myalgic encephalopathy (ME) Chronic
More informationLiving Well with MDS. Overview. What are the biggest physical and emotional challenges you are facing
Living Well with MDS Strategies for Optimizing Emotional and Physical Health Isabel Schuermeyer, MD Director, Psycho-Oncology Cleveland Clinic Paul Scribner, LISW Director, Patient Programs and Services
More informationBi-directional Relationship Between Poor Sleep and Work-related Stress: Management through transformational leadership and work organization
Bi-directional Relationship Between Poor Sleep and Work-related Stress: Management through transformational leadership and work organization Sleep & its Importance Most vital episode of human life! Psychological
More informationEmotional Adaptation after Cancer
Emotional Adaptation after Cancer Jesse Fann, MD, MPH Department of Psychiatry & Behavioral Sci, UW Clinical Research Division, FHCRC Director, Psychiatry & Psychology Service, SCCA Outline Fear of Recurrence
More informationPalliative Care: Expanding the Role Throughout the Patient s Journey. Dr. Robert Sauls Regional Lead for Palliative Care
Palliative Care: Expanding the Role Throughout the Patient s Journey Dr. Robert Sauls Regional Lead for Palliative Care 1 Faculty/Presenter Disclosure Faculty: Dr. Robert Sauls MD, with the Mississauga
More informationCancer-Related Fatigue (CRF) Management During and Following Cancer Treatment: Moving the Evidence into Practice
Cancer-Related Fatigue (CRF) Management During and Following Cancer Treatment: Moving the Evidence into Practice Sandra A. Mitchell, PhD, CRNP, AOCN, FAAN Research Scientist and Program Director; Outcomes
More informationSECTION 1. Children and Adolescents with Depressive Disorder: Summary of Findings. from the Literature and Clinical Consultation in Ontario
SECTION 1 Children and Adolescents with Depressive Disorder: Summary of Findings from the Literature and Clinical Consultation in Ontario Children's Mental Health Ontario Children and Adolescents with
More informationYOU REALLY NEED TO SLEEP: Several methods to improve your sleep
YOU REALLY NEED TO SLEEP: Several methods to improve your sleep Sleep is essential to our well-being. When humans fail to get good sleep over a period of time, numerous problems can occur. CAN T SLEEP!!
More informationAppendix F- Edmonton Symptom Assessment System (ESAS), Canadian Problem Checklist, and Distress Thermometer for Cancer Patients
Appendix F- Edmonton Symptom Assessment System (ESAS), Canadian Problem Checklist, and Distress Thermometer for Cancer Patients Screening Cancer Patients for Distress in Nova Scotia with the ESAS, CPC,
More informationManaging Psychosocial and Family Distress after Cancer Treatment
Managing Psychosocial and Family Distress after Cancer Treatment Information for cancer survivors Read this pamphlet to learn: What psychosocial distress is What causes distress What you can do Where to
More informationWho is at risk? What should we do in the clinic?
Cognitive Changes after Cancer Treatment Patricia A. Ganz, M.D. Professor, UCLA Schools of Medicine & Public Health Director, UCLA-LIVESTRONG Survivorship Center of Excellence Jonsson Comprehensive Cancer
More informationA Guide To Fibromyalgia
What Is Fibromyalgia? Fibromyalgia is a chronic condition that affects about 5 million Americans. Doctors diagnose fibromyalgia based on a patient's symptoms and physical exam. Patients experience pain
More informationCase Study 3. DSM Symptoms Present: [DSM criteria as evidenced by (with evidence from case study)]
Case Study 3 DSM Symptoms Present: [DSM criteria as evidenced by (with evidence from case study)] Insomnia Related to Generalized Anxiety Disorder A. The predominant complaint is difficulty initiating
More informationP08 Reversible loss of consciousness. E365 Aviation Human Factors
P08 Reversible loss of consciousness E365 Aviation Human Factors Need to sleep Sleep is a natural state of rest for the body and mind that involves the reversible loss of consciousness. You sleep to not
More informationManaging Common Side Effects of MDS Treatment Cindy Murray NP Malignant Hematology Princess Margaret Cancer Centre
Managing Common Side Effects of MDS Treatment Cindy Murray NP Malignant Hematology Princess Margaret Cancer Centre Choosing Treatment Recommendations Type of MDS How MDS is affecting you Availability of
More informationDr. Catherine Mancini and Laura Mishko
Dr. Catherine Mancini and Laura Mishko Interviewing Depression, with case study Screening When it needs treatment Anxiety, with case study Screening When it needs treatment Observation Asking questions
More informationBiopsychosocial Characteristics of Somatoform Disorders
Contemporary Psychiatric-Mental Health Nursing Chapter 19 Somatoform and Sleep Disorders Biopsychosocial Characteristics of Somatoform Disorders Unconscious transformation of emotions into physical symptoms
More informationUsing the DSM-5 in the Differential Diagnosis of Depression
Using the DSM-5 in the Differential Diagnosis of Depression Wayne Bentham, MD Clinical Assistant Professor Department of Psychiatry and Behavioral Sciences University of Washington School of Medicine Depressive
More informationChronic Pain Management Strategies
Chronic Pain Management Strategies Angela Gilbert, Psy.D. Licensed Psychologist Kensington Medical Center 2nd Annual Diabetes Wellness Day What We Will Cover Today What Is Chronic Pain And Chronic Pain
More informationOther significant mental health complaints
Other significant mental health complaints 2 Session outline Introduction to other significant mental health complaints Assessment of other significant mental health complaints Management of other significant
More informationThe impact of cancer and cancer treatments on sexuality and what can help. Trish Lymburner, MSW, RSW Lisa Roelfsema, MSW, RSW
The impact of cancer and cancer treatments on sexuality and what can help Trish Lymburner, MSW, RSW Lisa Roelfsema, MSW, RSW 1 Presenter Disclosure Presenters: Lisa Roelfsema, MSW, RSW and Trish Lymburner,
More informationSession outline. Introduction to depression Assessment of depression Management of depression Follow-up Review
Depression 1 Session outline Introduction to depression Assessment of depression Management of depression Follow-up Review 2 Activity 1: Person s story followed by group discussion Present the first person
More informationMindfulness as a Mediator of Psychological Wellbeing in a Stress Reduction Intervention for Cancer Patients - a randomized study
Mindfulness as a Mediator of Psychological Wellbeing in a Stress Reduction Intervention for Cancer Patients - a randomized study Richard Bränström Department of oncology-pathology Karolinska Institute
More informationBeyond Cancer Moving On
Beyond Cancer Moving On Today, people with cancer have a better chance at living a normal life than ever before in history. In fact, there are more than 10 million survivors people who have, or are living
More informationPAIN MANAGEMENT & MAXIMIZING QUALITY OF LIFE DURING TREATMENT
PAIN MANAGEMENT & MAXIMIZING QUALITY OF LIFE DURING TREATMENT Brandy Ficek, MD Medical Director of Quality of Life and Palliative Medicine Cancer Treatment Centers of America Rocky Mountain Blood Cancer
More informationHEALTH 3--DEPRESSION, SLEEP, AND HEALTH GOALS FOR LEADERS. To educate participants regarding the sleep wake cycle.
HEALTH 3--DEPRESSION, SLEEP, AND HEALTH GOALS FOR LEADERS Talk about the relationship between depression, sleep, and health problems. To educate participants regarding the sleep wake cycle. To provide
More informationAnxiety- Information and a self-help guide
Anxiety- Information and a self-help guide Anxiety Anxiety can be a very normal and healthy response to stressful situations, such as paying bills or sitting an exam. However, it becomes a problem when
More informationKaren Syrjala, PhD Co-Director, Survivorship Program
Karen Syrjala, PhD Co-Director, Survivorship Program 1. Who are survivors of cancer? 2. Why do you care about your needs as a survivor? 3. What can you do to stay well as a survivor? Who are Survivors?
More informationCaring for the Mind: Managing Depression and Anxiety. Highlights from 2017 ONS Congress
Caring for the Mind: Managing Depression and Anxiety Highlights from 2017 ONS Congress Mood and Anxiety Disorders: Symptoms of mood disorders Non-reactive mood, worthlessness, guilt, loss of interest,
More informationBBMS PARENT-TEACHER INSTITUTE PRESENTS= STRESS MANAGEMENT LEARN TO LET IT GO
BBMS PARENT-TEACHER INSTITUTE PRESENTS= STRESS MANAGEMENT LEARN TO LET IT GO HTTPS://WWW.YOUTUBE.COM/WATCH?V=MOSFLVXNBGK BY: CHRISTINA COLLINS & LAUREN MURPHY MULTI- TASKING = THE DIVISION OF ATTENTION
More informationBeyond Sleep Hygiene: Behavioral Approaches to Insomnia
Beyond Sleep Hygiene: Behavioral Approaches to Insomnia Rocky Garrison, PhD, CBSM Damon Michael Williams, RN, PMHNP-BC In House Counseling Laughing Heart LLC 10201 SE Main St. 12 SE 14 th Ave. Suite 10
More informationFatigue and Myeloma. information sheet
Fatigue and Myeloma Cancer related fatigue (CRF) is defined as a distressing, persistent and subjective feeling of physical, mental or emotional tiredness related to cancer and/or cancer treatment interfering
More informationSleep Hygiene. William M. DeMayo, M.D. John P. Murtha Neuroscience and Pain Institute Conemaugh Health System Johnstown, PA
Sleep Hygiene William M. DeMayo, M.D. John P. Murtha Neuroscience and Pain Institute Conemaugh Health System Johnstown, PA Why Is Sleep Important? Symptoms of Sleep Deprivation: Irritability / Poor Stress
More informationBringing It All Together Ways to Stay Motivated
Bringing It All Together Ways to Stay Motivated Adapted for Upstate Medical University by: Kristi Shaver, BS, RN, CDE, MS-CNS Student (2014) January 2014 Your new plan for diabetes care Feeling motivated?
More informationMeghan Cohen Coordinator, Center for Health and Wellbeing 0121 Eppley Recreation Center
Meghan Cohen Coordinator, Center for Health and Wellbeing 0121 Eppley Recreation Center mcohen@health.umd.edu Objectives What is wellness? How are UMD students doing? Stress Sleep Time Management Campus
More informationRESTore TM. Clinician Manual for Single User. Insomnia and Sleep Disorders. A step by step manual to help you guide your clients through the program
RESTore TM Insomnia and Sleep Disorders Clinician Manual for Single User A step by step manual to help you guide your clients through the program Version 10 July, 2016 Table of Contents Introduction...
More informationModule. Managing Feelings About. Heart Failure
Module 6 Managing Feelings About Heart Failure Taking Control of Heart Failure Contents Introduction 3 Common Feelings After a Diagnosis of Heart Failure 4 Recognizing Emotions After Diagnosis of Heart
More informationSleep and Traumatic Brain Injury (TBI)
Sleep and Traumatic Brain Injury (TBI) A resource for individuals with traumatic brain injury and their supporters This presentation is based on TBI Model Systems research and was developed with support
More informationNon Pharmacological Breathlessness and Fatigue Management
Non Pharmacological Breathlessness and Fatigue Management Breathlessness BREATHLESSNESS Breathlessness is the subjective sensation of breathing discomfort that varies in intensity Thoracic Society Dyspnoea-
More informationRiding the Emotional Roller Coaster of Survival. Kauser Ahmed PhD Psychologist/ Training Director Simms/Mann UCLA Center for Integrative Oncology
Riding the Emotional Roller Coaster of Survival Kauser Ahmed PhD Psychologist/ Training Director Simms/Mann UCLA Center for Integrative Oncology Goals for Talk Understand psychosocial challenges of survivorhood
More informationWomen, Mental Health, and HIV
Women, Mental Health, and HIV Together, we can change the course of the HIV epidemic one woman at a time. #onewomanatatime #thewellproject What is Mental Health? Refers to emotional, psychological, social
More informationChronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis/Encephalopathy (ME)
Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis/Encephalopathy (ME) This intervention (and hence this listing of competences) assumes that practitioners are familiar with, and able to deploy,
More informationSleep and mental wellbeing: exploring the links
Sleep and mental wellbeing: exploring the links Like most physiological functions, the length and quality of sleep is influenced by a host of biological, environmental and lifestyle factors. Across all
More informationImproving Your Sleep Course. Session 4 Dealing With a Racing Mind
Improving Your Sleep Course Session 4 Dealing With a Racing Mind Session 4 Dealing With a Racing Mind This session will: Help you to learn ways of overcoming the mental alertness, repetitive thoughts and
More informationImpact on our Mental Health. Biological Changes Psychological Changes Social Changes Professional Services Coping Skills
Impact on our Mental Health Biological Changes Psychological Changes Social Changes Professional Services Coping Skills Biological Changes After a brain injury, biological impacts may affect mental health
More informationManaging Chronic Pain
Managing Chronic Pain What Is Chronic Pain? Everyone feels pain sometimes the sharp stab of a twisted ankle, the throb of a headache, the muscle soreness that comes from too much activity. This type of
More informationCancer and Cognitive Functioning
Cancer and Cognitive Functioning Myron Goldberg, PhD, ABPP-CN Clinical Neuropsychologist Department of Rehabilitation Medicine University of Washington Medical Center Cognitive Functioning after Cancer
More informationPsychological Sleep Services Sleep Assessment
Psychological Sleep Services Sleep Assessment Name Date **************************************************** Insomnia Severity Index For each question, please CIRCLE the number that best describes your
More informationWHAT IS STRESS? increased muscle tension increased heart rate increased breathing rate increase in alertness to the slightest touch or sound
EXAM STRESS WHAT IS STRESS? Stress is part of the body s natural response to a perceived threat. We all experience it from time to time. When we feel under threat, our bodies go into fight or flight response,
More informationmaintaining gains and relapse prevention
maintaining gains and relapse prevention Tips for preventing a future increase in symptoms 3 If you do experience an increase in symptoms 8 What to do if you become pregnant again 9 2013 BC Reproductive
More informationNeurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D.
Neurology and Trauma: Impact and Treatment Implications Damien Dowd, M.A. & Jocelyn Proulx, Ph.D. Neurological Response to a Stressor Information from the senses goes to the thalamus which sends the information
More informationWHY CAN T I SLEEP? Deepti Chandran, MD
WHY CAN T I SLEEP? Deepti Chandran, MD Sleep and Aging How does sleep change as we age? Do we need less sleep as we get older? Can a person expect to experience more sleep problems or have a sleep disorder
More informationLiving with Stress. Choices to help your Boarding School Life.
Living with Stress Choices to help your Boarding School Life. STRESS: Stress is defined as an organism's total response to environmental demands or pressures. Can be a normal response, or more commonly
More information23/06/2015. Absolutely none!!
Absolutely none!! Child and adolescent Mental Health can we help? Dr Tina Nicholson CCFP Family Practitioner and Medical Lead, Cochrane Clinical Lecturer Dept Family Med. U of C. Member of CanReach Faculty
More informationCancer-Related Fatigue
Clinical in Oncology Cancer-Related Fatigue V.1.2009 Continue www.nccn.org Panel Members * Ann M. Berger, PhD, RN, AOCN # UNMC Eppley Cancer Center at The Nebraska Medical Center Amy Pickar Abernethy,
More informationPSYCHOTROPIC MEDICATION AND THE WORKPLACE. Dr. Marty Ewer 295 Fullarton Road Parkside
PSYCHOTROPIC MEDICATION AND THE WORKPLACE Dr. Marty Ewer 295 Fullarton Road Parkside 5063 82999281 Introduction Depression and anxiety commonly occur in people who work. The World Health Organization has
More informationLeslie R. Schover, PhD Department of Behavioral Science
Causes and Treatments of Low Sexual Desire in Breast Cancer Survivors Leslie R. Schover, PhD Department of Behavioral Science IMPORTANCE OF SEX TO BREAST CANCER SURVIVORS Livestrong 2006 Post-Treatment
More informationThe Wellbeing Plus Course
The Wellbeing Plus Course Resource: Good Sleep Guide The Wellbeing Plus Course was written by Professor Nick Titov and Dr Blake Dear The development of the Wellbeing Plus Course was funded by a research
More informationSexual Problems. Results of sexual problems
What leads to sexual problems? Side effects from certain medications Results of sexual problems Relationship difficulties What reduces sexual problems Medical treatment (if problem is biological) Medical
More informationStress. Chapter Ten McGraw-Hill Higher Education. All rights reserved.
Stress Chapter Ten What Is Stress? } Stress is the collective physiological and emotional responses to any stimulus that disturbs an individual s homeostasis } A stressor is any physical or psychological
More informationFaculty/Presenter Disclosure
A Little CBT I With My Tea Please: Cognitive Behavioural Therapy for insomnia (CBT I) and Its Use In the Treatment of Sleeplessness W. Jerome Alonso, MD Medical Director, Canadian Sleep Consultants Clinical
More informationStep 1: Help your patients come prepared to their appointment. Step 2: Important communication reminders for the first follow-up visit
Making the Most of the Follow-Up Visit It s not enough for a patient to keep their follow-up appointment the appointment must also be a good one. Here are important reminders for a clinician, particularly
More informationManaging Sleep Problems after Cancer
Managing Sleep Problems after Cancer For cancer survivors Read this resource to learn about: What a sleep problem is What causes it What you can do to improve your sleep When to talk to your doctor Please
More informationOctober 8, 2013 Teens and Stress Presented by: Susan Sakamoto, MSW, MHP, EMMHS, CMH
October 8, 2013 Teens and Stress Presented by: Susan Sakamoto, MSW, MHP, EMMHS, CMH susans@youtheastsideservices.org A lifeline for kids and families AGENDA Who Is YES? Let s Talk Stress o What is it?
More informationHow to Exercise with CFS
How to Exercise with CFS To equip people affected by CFS / ME with the skills for self-management towards a better quality of life. Adult CFS / ME Service January 2018 Review January 2019 HOW CAN I EXERCISE
More informationCLASSIFICATION AND TREATMENT PLANS
CLASSIFICATION AND TREATMENT PLANS C H A P T E R 2 EXPERIENCES OF CLIENT AND CLINICIAN PSYCHOLOGICAL DISORDER: EXPERIENCES OF CLIENT AND CLINICIAN Psychologist: Healthcare professional offering psychological
More informationPost-Traumatic Stress Disorder
Post-Traumatic Stress Disorder Teena Jain 2017 Post-Traumatic Stress Disorder What is post-traumatic stress disorder, or PTSD? PTSD is a disorder that some people develop after experiencing a shocking,
More informationten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment
ten questions you might have about tapering (and room for your own) an informational booklet for opioid pain treatment This booklet was created to help you learn about tapering. You probably have lots
More informationWellness along the Cancer Journey: Palliative Care Revised October 2015
Wellness along the Cancer Journey: Palliative Care Revised October 2015 Chapter 2: Palliative Care Palliative Care Rev. 10.8.15 Page 352 Group Discussion True False Not Sure 1. Palliative care is only
More informationunderstand the causes and effects of stress
A guide for patients to help understand the causes and effects of stress What is stress? Stress is unavoidable. It can be described as the pressure we all encounter in our daily lives. It is a normal physical
More informationYOUNG WITH STAGE IV: YOUR PATIENTS UNIQUE NEEDS
YOUNG WITH STAGE IV: YOUR PATIENTS UNIQUE NEEDS Pamela J. Ginsberg, Ph.D. Private Practice, Doylestown, PA Board of Directors: Cancer Support Community of Greater Philadelphia Staff Psychologist, Doylestown
More informationManaging Fatigue. A guide to help you understand and manage your fatigue.
Managing Fatigue A guide to help you understand and manage your fatigue East Cheshire Hospice Millbank Drive Macclesfield Cheshire SK10 3DR Physiotherapy / OT 01625 665689 Fax: 01625 666995 www.eastcheshirehospice.org.uk
More informationDepressive and Bipolar Disorders
Depressive and Bipolar Disorders Symptoms Associated with Depressive and Bipolar Disorders Characteristics of mood symptoms Affects a person s well being, school, work, or social functioning Continues
More informationSleep for Success. Kathy Somers , ext OVC. Stress Management and High Performance Clinic. November 25, 2015
Sleep for Success Kathy Somers Stress Management and High Performance Clinic 519 824-4120, ext. 52662 OVC November 25, 2015 Sleep debt is the most important factor in the quality or excellence of psychological
More informationMood Disorders for Care Coordinators
Mood Disorders for Care Coordinators David A Harrison, MD, PhD Assistant Professor, Dept of Psychiatry & Behavioral Sciences University of Washington School of Medicine Introduction 1 of 3 Mood disorders
More informationThree Sleep Disorders common among Cardiovascular Patients and their Implications for Bridging the Gap Between Soma and Psyche
Three Sleep Disorders common among Cardiovascular Patients and their Implications for Bridging the Gap Between Soma and Psyche Dr. Jaan Reitav, CPsych, CBSM. Certified in Behavioral Sleep Medicine Clinical
More information