Telephone interpersonal counseling with women with breast cancer: symptom management and quality of life.
ABSTRACT 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.
- SourceAvailable from: Emma Ream[Show abstract] [Hide abstract]
ABSTRACT: Fatigue is a common cancer-related symptom and exacerbated by chemotherapy. Psychological interventions for fatigue show promise. One, Beating Fatigue, was adapted for delivery by telephone and evaluated in an exploratory trial. Eight patients and 12 professionals contributed to focus groups that guided adaptation of the intervention. The intervention, modified for delivery by telephone using motivational interviewing, was tested in an exploratory trial. Forty-four patients were recruited to the trial and randomized between the intervention (n=23) and control (n=21). Outcome data were collected on fatigue intensity, fatigue distress, fatigue self-efficacy, anxiety and depression at baseline and following completion of chemotherapy. These data were augmented by interviews conducted to inform understanding of the intervention's mechanism, feasibility and acceptability. The intervention was both feasible and acceptable to patients and most reduced fatigue distress (Effect Size ES=0.62). It also reduced fatigue intensity (ES=0.18), fatigue self-efficacy (ES=-0.34), and anxiety (ES=0.31). It did not reduce depression. These preliminary data are encouraging and support the delivery of interventions for cancer-related fatigue by telephone. Motivational interviewing appeared key to the intervention's success. A larger definitive RCT is indicated. Practice Implications: Opportunities should be sought to deliver psychologically-based interventions for fatigue by telephone. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.Patient Education and Counseling 10/2014; 98(2). · 2.60 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: This meta‐analysis begins to organize the complex field of psycho‐oncology intervention for psychological distress using a two‐part analysis strategy: preliminary analyses of primary study design variables, reported here, followed by the analysis of variables of substantive interest (person and therapy characteristics) using a structure which accounts for the otherwise confounding potential of moderators found in preliminary analyses. Using 146 published and unpublished prospective controlled trials, outcomes were anxiety, depression, and general distress. Two design variables produced higher effects: studies recruiting patients with elevated baseline distress and/or with no history of distress; and studies with an untreated control group. Exclusion of nonrandomized trials was not empirically justified and exclusion for lack of blindness was also seen to be inappropriate.Clinical Psychology Science and Practice 03/2012; 19(1). · 2.92 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: We report a meta‐analysis seeking socio‐demographic and medical moderators of the effectiveness of psycho‐oncological interventions. The dataset comprised 146 published and unpublished prospective controlled trials where outcomes were anxiety, depression, and general distress. Analyses took into account the confounding potential of two study design features discovered in preliminary analyses, and produced a coherent pattern of moderation suggestive of the critical influence of elevated baseline distress. Being older, having lower income, being male, or having a cancer other than (early stage) breast cancer produced higher statistically significant or trend effects, and being single produced nonsignificant effects double in magnitude to effects produced by married patients. Elevated baseline distress itself produced a significantly higher effect. Implications for research and practice are discussed.Clinical Psychology Science and Practice 12/2012; 19(4). · 2.92 Impact Factor