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A randomised controlled trial of support group intervention after breast cancer treatment: Results on anxiety and depression
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
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2012 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 51, no 2, p. 198-207Article in journal (Refereed) Published
Abstract [en]

Background

Previous studies have demonstrated that between 20 and 30% of women treated for breast cancer have measurable signs of anxiety and depression compared with 6% in a population of healthy women. Depression has been proposed as a predictive factor for recurrence and survival. The aim of the present study was to evaluate if psychosocial support intervention could influence anxiety and depression during the first year after diagnosis.

Material and methods

Newly diagnosed breast cancer patients were randomised between April 2002 and November 2007 and stratified by adjuvant chemotherapy. Of 382 eligible patients, 191 + 191 patients were randomised to intervention group or control group, respectively. Control patients were subjected to standard follow-up routines. The Intervention group had support intervention at the Foundation Lustgarden Malardalen. The rehabilitation lasted one week on a residential basis followed by four days of follow-up two months later. We used the Swedish version of the HAD scale with a cut-off value greater than 10 for clinical symptoms of depression and anxiety.

Results

Support group intervention lowered anxiety over time (p < 0.001) but depression was unaffected (p = 0.610).

Conclusion

This prospective randomised trial of support group intervention in a large homogenous group of breast cancer women showed a statistically significant effect on lowering anxiety over time. No statistically significant effect of intervention could be seen on depression.

Place, publisher, year, edition, pages
2012. Vol. 51, no 2, p. 198-207
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-169093DOI: 10.3109/0284186X.2011.610352ISI: 000299385600007OAI: oai:DiVA.org:uu-169093DiVA, id: diva2:506070
Available from: 2012-02-27 Created: 2012-02-23 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Support Group Intervention in Primary Breast Cancer: Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
Open this publication in new window or tab >>Support Group Intervention in Primary Breast Cancer: Health-Related Quality of Life, with Special Reference to Anxiety, Depression and Fatigue
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to investigate in a (RCT) the effect of support group intervention in women with primary breast cancer in the short term, and with a long-term follow-up. Women with primary breast cancer were randomized between April 2002 and November 2007 and stratified according to adjuvant treatment with chemotherapy. Of 382 eligible patients, 191+191 patients were randomized to intervention and control groups respectively. Control patients were subjected to standard follow-up procedures. Patients in the intervention group received support intervention at the Foundation of Lustgården Mälardalen during one week followed by four days of follow-up two months later. Patients in intervention and control groups filled in questionnaires at baseline, after 2, 6 and 12 months and in the long-term follow-up after a mean of 6.5 years. In paper I, we studied the effect of the intervention on anxiety and depression measured by the HAD scale and we could show that a significantly lower proportion of women in the intervention group had high anxiety scores compared with women in the control group after 12 months; however, the proportion of women with high depression scores were unaffected. In paper II, we studied the effect of the intervention on fatigue and health-related quality of life (HRQoL) measured by the Norwegian version of the fatigue questionnaire (FQ) and EORTC-QLQ 30 and BR 23.We could not demonstrate any significant effect of the intervention. In paper III, we studied the effect of the intervention on sick-leave, healthcare utilization and the effect of the intervention in economic terms. We used a specially formulated questionnaire. There was a trend towards longer sick leave and more health-care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p= 0.0036). In paper IV, we studied the long-term effects of the support intervention on anxiety, depression, fatigue and HRQoL. We could show a significant effect of the intervention on cognitive function, body image, future perspective and fatigue, the largest effect was seen among women who received chemotherapy; however, no effects on anxiety and depression were demonstrated.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. p. 77
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 819
Keywords
Support group intervention, breast cancer, anxiety, depression, fatigue, health-related quality of life, sick-leave, health-care utilization
National Category
Clinical Medicine
Research subject
Oncology
Identifiers
urn:nbn:se:uu:diva-182083 (URN)978-91-554-8485-9 (ISBN)
Public defence
2012-11-17, Aulan, Ingång 21, Västmanlands sjukhus Västerås, Västerås, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2012-10-26 Created: 2012-10-03 Last updated: 2013-01-23Bibliographically approved

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Granstam Björneklett, HelenaRosenblad, AndreasOjutkangas, Marja-LeenaBergkvist, Leif

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