Laura Porter

Overview:

My research focuses on developing and evaluating behavioral interventions to help patients and their family members cope with the symptoms and psychological demands associated with chronic and life-limiting illness.

Positions:

Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Professor in the School of Nursing

School of Nursing
School of Nursing

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 1996

State University of New York at Stony Brook

Grants:

Feasibility of a Couple-based Intervention for Parents of Children with Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Caregiver-Assisted Pain Coping Skills Training for Dementia

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Role
Principal Investigator
Start Date
End Date

Yoga-based Symptom Management for Metastatic Breast Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Coping Skills Training for Spinal Cord Stimulator Patients

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Partner-Assisted Emotional Disclosure for GI Cancer

Administered By
Psychiatry & Behavioral Sciences, Behavioral Medicine
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: a pilot randomised clinical trial.

BACKGROUND: Patients who are sick enough to be admitted to an intensive care unit (ICU) commonly experience symptoms of psychological distress after discharge, yet few effective therapies have been applied to meet their needs. METHODS: Pilot randomised clinical trial with 3-month follow-up conducted at two academic medical centres. Adult (≥18 years) ICU patients treated for cardiorespiratory failure were randomised after discharge home to 1 of 3 month-long interventions: a self-directed mobile app-based mindfulness programme; a therapist-led telephone-based mindfulness programme; or a web-based critical illness education programme. RESULTS: Among 80 patients allocated to mobile mindfulness (n=31), telephone mindfulness (n=31) or education (n=18), 66 (83%) completed the study. For the primary outcomes, target benchmarks were exceeded by observed rates for all participants for feasibility (consent 74%, randomisation 91%, retention 83%), acceptability (mean Client Satisfaction Questionnaire 27.6 (SD 3.8)) and usability (mean Systems Usability Score 89.1 (SD 11.5)). For secondary outcomes, mean values (and 95% CIs) reflected clinically significant group-based changes on the Patient Health Questionnaire depression scale (mobile (-4.8 (-6.6, -2.9)), telephone (-3.9 (-5.6, -2.2)), education (-3.0 (-5.3, 0.8)); the Generalized Anxiety Disorder scale (mobile -2.1 (-3.7, -0.5), telephone -1.6 (-3.0, -0.1), education -0.6 (-2.5, 1.3)); the Post-Traumatic Stress Scale (mobile -2.6 (-6.3, 1.2), telephone -2.2 (-5.6, 1.2), education -3.5 (-8.0, 1.0)); and the Patient Health Questionnaire physical symptom scale (mobile -5.3 (-7.0, -3.7), telephone -3.7 (-5.2, 2.2), education -4.8 (-6.8, 2.7)). CONCLUSIONS: Among ICU patients, a mobile mindfulness app initiated after hospital discharge demonstrated evidence of feasibility, acceptability and usability and had a similar impact on psychological distress and physical symptoms as a therapist-led programme. A larger trial is warranted to formally test the efficacy of this approach. TRIAL REGISTRATION NUMBER: Results, NCT02701361.
Authors
Cox, CE; Hough, CL; Jones, DM; Ungar, A; Reagan, W; Key, MD; Gremore, T; Olsen, MK; Sanders, L; Greeson, JM; Porter, LS
MLA Citation
URI
https://scholars.duke.edu/individual/pub1319405
PMID
29793970
Source
pubmed
Published In
Thorax
Volume
74
Published Date
Start Page
33
End Page
42
DOI
10.1136/thoraxjnl-2017-211264

Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study.

PURPOSE: Breast cancer patients commonly experience sexual concerns, yet rarely discuss them with clinicians. The study examined patient and provider experiences and preferences related to communication about breast cancer-related sexual concerns with the goal of informing intervention development. METHODS: Patient data (n = 28) were derived from focus groups and interviews with partnered and unpartnered women treated for breast cancer reporting sexual concerns. Provider data (n = 11) came from interviews with breast cancer oncologists and nurse practitioners. Patient and provider data were analyzed separately using the framework method of qualitative analysis. RESULTS: Findings revealed individual and institutional barriers to effective communication about sexual concerns and highlighted key communication facilitators (e.g., a positive patient-provider relationship, patient communication as a driver of provider communication, and vice versa). Patients expressed preferences for open, collaborative communication; providers expressed preferences for focused intervention targets (identifying concerns, offering resources/referrals) and convenient format. A model of effective communication of sexual concerns was developed to inform communication interventions. CONCLUSIONS: Findings suggest that to improve patient-provider communication about sexual concerns, knowledge and skills-based interventions that activate patients and that equip providers for effective discussions about sexual concerns are needed, as are institutional changes that could incentivize such discussions.
Authors
Reese, JB; Beach, MC; Smith, KC; Bantug, ET; Casale, KE; Porter, LS; Bober, SL; Tulsky, JA; Daly, MB; Lepore, SJ
MLA Citation
Reese, Jennifer Barsky, et al. “Effective patient-provider communication about sexual concerns in breast cancer: a qualitative study..” Support Care Cancer, vol. 25, no. 10, 2017, pp. 3199–207. Pubmed, doi:10.1007/s00520-017-3729-1.
URI
https://scholars.duke.edu/individual/pub1244578
PMID
28451911
Source
pubmed
Published In
Support Care Cancer
Volume
25
Published Date
Start Page
3199
End Page
3207
DOI
10.1007/s00520-017-3729-1

Emotional arousal predicts observed social support in German and American couples talking about breast cancer.

Social support in couples often occurs during conversations and is an important predictor of positive outcomes in patients with breast cancer. Even though talking about cancer may be upsetting, vocally expressed emotional arousal and its association with social support have not been examined. The goal of this study was to examine the role of vocally encoded emotional arousal and social support behaviors in 129 German and American couples, assessed at baseline of clinical trials for women with breast cancer and their male partners. Range of fundamental frequency was used as a measure of expressed emotional arousal during videotaped interactions in which the women shared cancer-related concerns. Social support behaviors were assessed as specific social support behaviors at the talk-turn level (positive, neutral, and negative) and broader communication behaviors also relevant to social support at the global level (depth and articulation, caring, quality of communication) using the Social Support Interaction Coding System (Bradbury & Pasch, 1994). Data were analyzed using actor-partner interdependence models. Women displayed more positive, fewer neutral support-receiving behaviors, and greater depth and articulation if their own emotional arousal was higher. Women also displayed more neutral and (at the trend level) fewer positive support-receiving behaviors if their partners' emotional arousal was higher. Men's behaviors were not associated with their own or women's emotional arousal. Results indicate that it may be adaptive for women with cancer to openly experience their distress during social support conversations with their partners; high emotional arousal of the partners may interfere with this process.
Authors
Fischer, MS; Baucom, DH; Baucom, BR; Weusthoff, S; Hahlweg, K; Atkins, DC; Porter, LS; Zimmermann, T
MLA Citation
Fischer, Melanie S., et al. “Emotional arousal predicts observed social support in German and American couples talking about breast cancer..” J Fam Psychol, vol. 29, no. 5, Oct. 2015, pp. 744–54. Pubmed, doi:10.1037/fam0000092.
URI
https://scholars.duke.edu/individual/pub1095334
PMID
26075737
Source
pubmed
Published In
J Fam Psychol
Volume
29
Published Date
Start Page
744
End Page
754
DOI
10.1037/fam0000092

IMPROVING PATIENT-PROVIDER COMMUNICATION IN ADVANCED CANCER: DEVELOPMENT OF A WEB-BASED INTERVENTION TO HELP PATIENTS EXPRESS EMOTIONAL CONCERNS

Authors
Porter, LS; Pollak, K; Farrell, D; Tulsky, J
MLA Citation
Porter, Laura S., et al. “IMPROVING PATIENT-PROVIDER COMMUNICATION IN ADVANCED CANCER: DEVELOPMENT OF A WEB-BASED INTERVENTION TO HELP PATIENTS EXPRESS EMOTIONAL CONCERNS.” Annals of Behavioral Medicine, vol. 45, SPRINGER, 2013, pp. S82–S82.
URI
https://scholars.duke.edu/individual/pub1244579
Source
wos
Published In
Annals of Behavioral Medicine
Volume
45
Published Date
Start Page
S82
End Page
S82

Psychosocial issues in cancer pain.

Cancer pain is a complex and multidimensional experience that affects and is affected by psychological and social factors. This article reviews recent research that points to a number of key psychosocial factors associated with pain, including psychological distress, coping, and social support, as well as the impact of socioeconomic factors on barriers to pain management. We also review recent research suggesting that psychosocial interventions, including education, coping-skills training, and hypnosis, may be useful adjuncts to medical management of pain. Clinical implications and recommendations for future research are discussed.
MLA Citation
Porter, Laura S., and Francis J. Keefe. “Psychosocial issues in cancer pain..” Curr Pain Headache Rep, vol. 15, no. 4, Aug. 2011, pp. 263–70. Pubmed, doi:10.1007/s11916-011-0190-6.
URI
https://scholars.duke.edu/individual/pub779836
PMID
21400251
Source
pubmed
Published In
Curr Pain Headache Rep
Volume
15
Published Date
Start Page
263
End Page
270
DOI
10.1007/s11916-011-0190-6