Telephone Interpersonal Counseling With Women With Breast Cancer: Symptom Management and Quality of Life

College of Nursing, University of Arizona, Tucson, AZ, USA.
Oncology Nursing Forum (Impact Factor: 2.79). 04/2005; 32(2):273-9. DOI: 10.1188/05.ONF.273-279
Source: PubMed


To examine the effectiveness of a telephone interpersonal counseling (TIP-C) intervention compared to a usual care attentional control for symptom management (depression and fatigue) and quality of life (positive and negative affect, stress) for women with breast cancer.
Experimental with repeated measures.
Academic cancer center and urban, private oncology offices.
48 women with breast cancer who were in their mid-50s, married, and employed at the time of the study.
Women were assigned to either the six-week TIP-C or attentional usual care groups. Women were matched on stage and treatment. Data were collected at baseline, after the six interventions, and one month postintervention. Measures included the Center for Epidemiologic Studies Depression Scale, Positive and Negative Affect Schedule, Multidimensional Fatigue Inventory, and Index of Clinical Stress.
Depression, positive and negative affect, fatigue, and stress.
Women in the intervention group experienced decreases in depression, fatigue, and stress over time and increases in positive affect.
The preliminary results partially supported the effectiveness of TIP-C for symptom management and quality of life. The authors hypothesized that decreased depression, reduced negative affect, decreased stress, decreased fatigue, and increased positive affect over time would be the resulting psychosocial effects, given the theoretical underpinnings of the intervention.
Nurses need to assess the quantity and quality of the social support network early in treatment; women with less social support need to be referred to counseling and support services. Because these women have limited participation in face-to-face interventions, they should be encouraged to participate in telephone or online support programs or in other programs or organizations (e.g., churches, social clubs) that would provide support.

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Available from: Terry A Badger, Jun 11, 2015
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    • "The intervention reduces reports of social disruption and increases positive states of mind and benefit finding. Badger et al., 2005 "
    Anales de Psicología 05/2015; · 0.50 Impact Factor
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    • "It was concluded that this nurse-directed intervention improved psychological symptoms for patients with cancer. Badger et al. (2005) examined the effectiveness of telephone counseling compared to usual care on symptom management and quality of life for women (n = 48) with breast cancer. Findings indicated that women in the intervention group had decreased depression, fatigue, and stress over time and increases in positive affect. "
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    ABSTRACT: Throughout the illness trajectory, women with breast cancer experience issues that are related to physical, emotional, and social adjustment. Despite a general consensus that state-of-the-art treatment for breast cancer should include educational and counseling interventions to reduce illness or treatment-related symptoms, there are few prospective, theoretically based, phase-specific randomized, controlled trials that have evaluated the effectiveness of such interventions in promoting adjustment. The aim of this study is to examine the physical, emotional, and social adjustment of women with early-stage breast cancer who received psychoeducation by videotapes, telephone counseling, or psychoeducation plus telephone counseling as interventions that address the specific needs of women during the diagnostic, postsurgery, adjuvant therapy, and ongoing recovery phases of breast cancer. Primary data from a randomized controlled clinical trial. Three major medical centers and one community hospital in New York City. A total of 249 patients were randomly assigned to either the control group receiving usual care or to one of the three intervention groups. The interventions were administered at the diagnostic, postsurgery, adjuvant therapy, and ongoing recovery phases. Analyses were based on a mixed model analysis of variance. MAIN RESEARCH VARIABLES AND MEASUREMENT: Physical adjustment was measured by the side effects incidence and severity subscales of the Breast Cancer Treatment Response Inventory (BCTRI) and the overall health status score of the Self-Rated Health Subscale of the Multilevel Assessment Instrument. Emotional adjustment was measured using the psychological well-being subscale of the Profile of Adaptation to Life Clinical Scale and the side effect distress subscale of BCTRI. Social adjustment was measured by the domestic, vocational, and social environments subscales of the Psychosocial Adjustment to Illness Scale. Patients in all groups showed improvement over time in overall health, psychological well-being, and social adjustment. There were no significant group differences in physical adjustment, as measured by side effect incidence, severity, or overall health. There was poorer emotional adjustment over time in the usual care (control) group as compared to the intervention groups on the measure of side effect distress. For the telephone counseling group, there was a marked decline in psychological well-being from the adjuvant therapy phase through the ongoing recovery phase. There were no significant group differences in the dimensions of social adjustment. The longitudinal design of this study has captured the dynamic process of adjustment to breast cancer, which in some aspects and at various phases has been different for the control and intervention groups. Although patients who received the study interventions improved in adjustment, the overall conclusion regarding physical, emotional, and social adjustment is that usual care, which was the standard of care for women in both the usual care (control) and intervention groups, supported their adjustment to breast cancer, with or without additional interventions. The results are important to evidence-based practice and the determination of the efficacy and cost-effectiveness of interventions in improving patient outcomes. There is a need to further examine adjustment issues that continue during the ongoing recovery phase. Psychoeducation by videotapes and telephone counseling decreased side effect distress and side effect severity and increased psychological well-being during the adjuvant therapy phase. All patients in the control and intervention groups improved in adjustment. Adjustment issues are still present in the ongoing recovery phase.
    Applied nursing research: ANR 05/2010; 25(1):3-16. DOI:10.1016/j.apnr.2009.10.003 · 0.73 Impact Factor
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    • "Participants in this study were part of a larger investigation of interpersonal counseling interventions for women with breast cancer and their partners (see Badger et al., 2005) and only those details relevant to the present analyses are included here. Participants were recruited from a regional cancer center, oncologists' offices, and support groups. "
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    ABSTRACT: The aim of this investigation was to test whether interdependence in dyads living with breast cancer could account for person-partner crossover effects in distress outcomes. The sample consisted of 95 dyads with early-stage breast cancer. By using reciprocal dyadic data from women with breast cancer and their partners, we fit a structural equation model of the actor-partner interdependence model to examine the interaction of participants' depression and stress in predicting their partner's health outcomes. Results revealed a pattern of influence whereby the interaction of high levels of depression coupled with high levels of stress in women with breast cancer was associated with lowered physical health and well-being in their partners. Although depression seemed to be the key mechanism in predicting distressing outcomes, when depression was combined with any additional stress, the level of physical distress was significantly greater. Results provided preliminary empirical support for crossover effects in the physical well-being of close relational partners in a cancer-related context. Further, results showed that distressing outcomes need not be limited to emotional distress but can also include physical distress. The findings from this study illustrate why it is not sufficient to concentrate care solely on the patient with cancer. Monitoring the social well-being of patients as they go through the cancer process could be as important as assessing their psychological state or other peripheral biomarkers. This line of inquiry would be advanced by including methods other than self-report in assessments of psychological and physical health.
    Journal of Consulting and Clinical Psychology 02/2010; 78(1):121-5. DOI:10.1037/a0017724 · 4.85 Impact Factor
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