Rebecca Shelby

Overview:

Rebecca Shelby, Ph.D. is an Assistant Professor in the Department of Psychiatry and Behavioral Sciences at Duke University and the Director of Education and Training for the Duke Cancer Patient Support Program.  Dr. Shelby is a member of the Duke Pain Prevention and Treatment Research Program and the Duke Cancer Control and Population Sciences Program. Dr. Shelby completed her graduate training in clinical psychology at the Ohio State University and her clinical internship and postdoctoral fellowship at Duke University Medical Center.  Her research focuses on developing and evaluating behavioral interventions for cancer patients, management of cancer pain and treatment side effects, and improving adherence to recommended care. Dr. Shelby serves on the Duke clinical psychology internship faculty and supervises clinical psychology fellows, interns, and clinical psychology graduate practicum students completing clinical rotations as part of the Duke Cancer Patient Support Program.   

Positions:

Associate Professor in Psychiatry and Behavioral Sciences

Psychiatry & Behavioral Sciences, Behavioral Medicine
School of Medicine

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2006

Ohio State University

Grants:

Improving Adherence to Recommended Surveillance in Breast Cancer Survivors

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

Publications:

Detecting geriatric needs in older patients with breast cancer through use of a brief geriatric screening tool.

INTRODUCTION: Identification of geriatric syndromes is important for determining functional age and optimizing care for people with cancer. Based on administration of a geriatric screening tool, we aimed to describe needed resources for geriatric syndromes, including lack of social support, depressed mood, deficits in instrumental and activities of daily living (IADL/ADL), falls, nutritional issues, polypharmacy, ability to pay for medications, and memory deficits, in a population of patients with breast cancer. METHODS: Consecutive medical oncology patients with breast cancer age 65 years and older, seen at a tertiary care center, completed a screening tool, adapted from Overcash 2006, consisting of a nurse-administered memory assessment and a one-page, self-administered questionnaire. Responses identified geriatric syndromes. Demographics and clinical information were retrospectively gathered. Frequencies and means were used to describe data. RESULTS: From January 2012 through July 2014, patients (n = 429) completed the screening tool as part of routine care. Study group had mean age 76 years (range 65-89), mean time since diagnosis 6.5 years, 91% non-metastatic disease, mean Charlson Comorbidity score 1.8 (range 0-10). Treatment included partial mastectomy (49%), adjuvant radiation (43%), chemotherapy (25%), and endocrine therapy (61%). The screening tool identified need for social support (8%); depression (31%); mobility issues (20%); falls (28%); nutritional needs (33%); polypharmacy (83%); and memory deficit (19%). CONCLUSION: This screening tool identified geriatric syndromes requiring attention in many patients with breast cancer presenting for medical oncology appointments. In oncology practice, need for referral networks to address geriatric syndromes should be assessed.
Authors
Kikuchi, R; Broadwater, G; Shelby, R; Robertson, J; Zullig, LL; Maloney, B; Meyer, C; Mungal, D; Marcom, PK; Kanesvaran, R; White, H; Kimmick, G
MLA Citation
Kikuchi, Robin, et al. “Detecting geriatric needs in older patients with breast cancer through use of a brief geriatric screening tool..” J Geriatr Oncol, Apr. 2019. Pubmed, doi:10.1016/j.jgo.2019.04.010.
URI
https://scholars.duke.edu/individual/pub1381109
PMID
31005647
Source
pubmed
Published In
J Geriatr Oncol
Published Date
DOI
10.1016/j.jgo.2019.04.010

Impact of Sodium Bicarbonate-Buffered Lidocaine on Patient Pain During Image-Guided Breast Biopsy.

PURPOSE: This randomized, double-blind controlled study evaluated the effectiveness of sodium bicarbonate-buffered lidocaine on reducing pain during imaging-guided breast biopsies. MATERIALS AND METHODS: This prospective, HIPAA-compliant study randomly assigned 85 women undergoing ultrasound- or stereotactic-guided core-needle breast biopsies to receive intradermally and intraparenchymally either 1% lidocaine buffered with sodium bicarbonate (9:1 ratio) (bicarbonate study group) or 1% lidocaine alone (control group). Pain was evaluated using a 0-to-10 Likert pain scale during both intradermal and intraparenchymal anesthesia injections and during tissue sampling. Prebiopsy breast pain, anxiety, medical history, demographics, biopsy type, radiologist level of training, breast density, and lesion histology were recorded. Data were analyzed using analysis of variance and analysis of covariance. RESULTS: Unadjusted mean pain scores were 1.47 and 2.07 (study and control groups, respectively; P = .15) during intradermal injections, and 1.84 and 2.98 (study and control groups, respectively; P = .03) during intraparenchymal injections. Tissue sampling mean pain scores were .81 and 1.71 (study and control groups, respectively; P = .07). Moderator analyses found (1) among patients with preprocedural pain, those in the bicarbonate group experienced less intradermal injection pain (0.85 ± 1.23) than patients in the control group (2.50 ± 2.09); (2) among patients with fatty or scattered fibroglandular tissue, those in the bicarbonate group (1.35 ± 1.95) experienced less intraparenchymal injection pain than the control group (3.52 ± 3.13); and (3) during ultrasound-guided biopsies, patients in the bicarbonate group experienced less tissue-sampling pain (0.23 ± 0.63) than the control group (1.79 ± 3.05). CONCLUSIONS: Overall, buffering lidocaine with sodium bicarbonate significantly reduced pain during intraparenchymal injections, and additional pain reduction was found in certain patient subgroups during intradermal injections, intraparenchymal injections, and tissue sampling.
Authors
MLA Citation
Vasan, Alison, et al. “Impact of Sodium Bicarbonate-Buffered Lidocaine on Patient Pain During Image-Guided Breast Biopsy..” J Am Coll Radiol, vol. 14, no. 9, Sept. 2017, pp. 1194–201. Pubmed, doi:10.1016/j.jacr.2017.03.026.
URI
https://scholars.duke.edu/individual/pub1254715
PMID
28527821
Source
pubmed
Published In
Journal of the American College of Radiology : Jacr
Volume
14
Published Date
Start Page
1194
End Page
1201
DOI
10.1016/j.jacr.2017.03.026

ANXIETY AND NEGATIVE MOOD FOLLOWING MAMMOGRAPHY SCREENING FOR BREAST CANCER

Authors
Edmond, SN; Shelby, RA; Keefe, FJ; Soo, MS; Skinner, CS; Ahrendt, G; Manculich, J; Sumkin, JH; Zuley, M; Bovbjerg, DH
MLA Citation
Edmond, Sara N., et al. “ANXIETY AND NEGATIVE MOOD FOLLOWING MAMMOGRAPHY SCREENING FOR BREAST CANCER.” Annals of Behavioral Medicine, vol. 49, SPRINGER, Apr. 2015, pp. S6–S6.
URI
https://scholars.duke.edu/individual/pub1126000
Source
wos
Published In
Annals of Behavioral Medicine
Volume
49
Published Date
Start Page
S6
End Page
S6

The context of pain in arthritis: self-efficacy for managing pain and other symptoms.

Arthritis pain may be best understood in the context of a biospychosocial model of pain. The biopsychosocial model of pain suggests that adjustment to arthritis pain is multifaceted and is influenced by biological, psychological, and social factors. One psychological construct that appears to be particularly helpful in understanding arthritis pain is patients' self-efficacy for managing pain and other symptoms. In recent work, investigators have included self-efficacy for managing pain and other symptoms as key outcome measures in behavioral and psychosocial intervention studies. The goal of this article was to review recent intervention studies that have examined the effect of behavioral and psychosocial interventions on self-efficacy for managing pain and other symptoms. Throughout the article, we make several suggestions for future clinical and research considerations regarding the role of self-efficacy for managing pain and other symptoms in the context of arthritis pain.
Authors
MLA Citation
Somers, Tamara J., et al. “The context of pain in arthritis: self-efficacy for managing pain and other symptoms..” Curr Pain Headache Rep, vol. 16, no. 6, Dec. 2012, pp. 502–08. Pubmed, doi:10.1007/s11916-012-0298-3.
URI
https://scholars.duke.edu/individual/pub797941
PMID
23054977
Source
pubmed
Published In
Curr Pain Headache Rep
Volume
16
Published Date
Start Page
502
End Page
508
DOI
10.1007/s11916-012-0298-3

Validation of the Patient Care Monitor (Version 2.0): a review of system assessment instrument for cancer patients.

CONTEXT: The Patient Care Monitor (PCM) is a review of systems survey delivered by means of an electronic patient-reported outcomes (ePRO) data capture system that uses wireless tablet computers. Although the PCM 1.0 is validated, the updated PCM 2.0 has not been validated nor tested in the academic setting. OBJECTIVES: To validate and test the PCM 2.0 in three cancer populations. METHODS: Two hundred seventy-five individuals participated in three clinical trials enrolling breast (n=65), gastrointestinal (n=113), and lung (n=97) cancer patients. Internal consistency was evaluated using Cronbach's alpha coefficients calculated for six PCM subscales (general physical symptoms, treatment side effects, distress, despair, impaired performance, and impaired ambulation) and a Quality-of-Life Index. Construct validity was evaluated through Pearson's correlation between PCM subscales and subscales of the Functional Assessment of Cancer Therapy--General (FACT-G), the M.D. Anderson Symptom Inventory (MDASI), and the Functional Assessment of Chronic Illness Therapy--Fatigue (FACIT-F). The participants had the following characteristics: mean age was 58 years (standard deviation: 11), 52% were females, 79% were whites, 17% were blacks, 62% had no college degree, and 78% had metastatic or recurrent disease. RESULTS: Raw and normalized scores for PCM 2.0 subscales were internally consistent across study cohorts. PCM 2.0 subscales correlated significantly (P<0.05) with the corresponding subscales on FACT-G, MDASI, and FACIT-F, with the exception of FACT-G social well-being, particularly for the lung cancer population. These correlations demonstrated construct validity. PCM 2.0 results followed expected patterns by cancer etiology. Prior reports demonstrate patient satisfaction with PCM 2.0. CONCLUSION: Within three unique academic oncology populations, PCM 2.0 is a valid ePRO instrument for assessing symptoms with seven patient-centered subscale or index domains.
Authors
Abernethy, AP; Zafar, SY; Uronis, H; Wheeler, JL; Coan, A; Rowe, K; Shelby, RA; Fowler, R; Herndon, JE
MLA Citation
Abernethy, Amy P., et al. “Validation of the Patient Care Monitor (Version 2.0): a review of system assessment instrument for cancer patients..” J Pain Symptom Manage, vol. 40, no. 4, Oct. 2010, pp. 545–58. Pubmed, doi:10.1016/j.jpainsymman.2010.01.017.
URI
https://scholars.duke.edu/individual/pub747229
PMID
20579839
Source
pubmed
Published In
J Pain Symptom Manage
Volume
40
Published Date
Start Page
545
End Page
558
DOI
10.1016/j.jpainsymman.2010.01.017