4.4 Article

Breast cancer: Education, counseling, and adjustment among patients and partners: A randomized clinical trial

Journal

NURSING RESEARCH
Volume 57, Issue 3, Pages 199-213

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.NNR.0000319496.67369.37

Keywords

breast cancer adjustment; partner adjustment; psychoeducation; randomized controlled trial; symptom experience; telephone counseling

Categories

Funding

  1. NCI NIH HHS [1 R01 CA90644-01A1] Funding Source: Medline

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Background: Although various forms of psychoeducation and counseling interventions have been examined among patients with a variety of diagnoses, the unique contribution of phase-specific psychoeducation and telephone counseling (TC) to the ongoing process of adjustment has not been explored among patients with breast cancer and their partners. Objective: To conduct a randomized controlled clinical trial of phase-specific evidence-based psychoeducation and TC interventions to enhance emotional, physical, and social adjustments in patients with breast cancer and their partners. Methods: A purposive sample of 249 patient-partner dyads were assigned randomly to one of four groups: (a) control group receiving disease management (DM), (b) standardized psychoeducation (SE), (c) TC, or (d) standardized psychoeducation plus telephone counseling (SE + TC). Data were collected at baseline, diagnostic, postsurgery, adjuvant therapy, and ongoing recovery phases measuring emotional, physical, and social adjustments. Results: Patients showed poorer adjustment over time in the DM group relative to those receiving interventions on selected measures of emotional adjustment. All patients showed improvement over time in overall health and adjustment in social and vocational environments. Partners in all groups exhibited improvement over time for measures of adjustment in the social environment but no changes in psychological well-being or overall health. Partners in the TC group had poorer scores on physical symptoms compared with the SE + TC group and poorer vocational scores compared with the DM group. Discussion: Findings from this study provide preliminary support for the value of phase-specific SE and TC interventions to enhance selected adjustment outcomes for patients with breast cancer and their partners.

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