Introduction
With a background in clinical psychology and public
health, I have a keen interest in assessing how individuals adjust
to their illness and medical treatment. For me, the NKI is the
perfect place to do high-quality applied research that will make a
difference for patients and their families. It also gives me a base
from which I can link to many international research groups.
Health-related quality of life assessment in clinical
research and clinical practice
Over the past 25 years I have championed the development
and use of standardized questionnaires for assessing the
health-related quality of life (HRQOL) of patient with cancer. I
believe that, If you provide physicians and nurses with structured
information about the functional health, symptom experience and
quality of life of their patients, they will be better attuned to
their patients' problems and limitations, and can thus provide
better care, either directly or through referral to appropriate
supportive care services. Although our questionnaires were
initially developed for use in research settings, it has been
exciting to see them move into the clinic. Patients can now
complete such questionnaires on a touchscreen computer in-clinic,
or via internet at home. Their digital responses can be integrated
into the electronic medical record, and can be used at point of
care (i.e., during clinical encounters) to facilitate
doctor-patient and nurse-patient communication. At the same time,
when aggregated across patients, these HRQOL data can inform
treatment policy and quality of care initiatives on a system wide
level.
Development and evaluation of psychosocial and
behavioral interventions
In a related line of research, we are developing and
evaluating a range of behavioral interventions to relieve symptoms
and enhance the physical and psychosocial well-being of our
patients. For example, we recently completed a large scale,
multicenter study in which we were able to demonstrate that both
counseling (cognitive behavioral therapy) and physical exercise are
effective in reducing the burden of endocrine symptoms experienced
by young breast cancer patients who have gone into premature,
treatment-induced menopause. Similarly, we are currently
investigating the efficacy of low and moderate intensity physical
exercise as a means of minimizing fatigue and maintaining physical
fitness among breast and colon cancer patients during adjuvant
chemotherapy. We are also studying the usefulness of an
internet-based sexual therapy program for women with breast cancer.
All of our research is aimed at enhancing the physical and
psychosocial functioning and well-being, and the quality of life of
our patients and their families.